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Diagnostic accuracy of 99mTc-sestamibi SPECT/CT for detecting renal oncocytomas and other benign renal lesions: a systematic review and meta-analysis

  • Kidneys, Ureters, Bladder, Retroperitoneum
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Abdominal Radiology Aims and scope Submit manuscript

Abstract

Purpose

The primary objectives of this systematic review and meta-analysis were to evaluate the diagnostic accuracy of 99mTc-sestamibi SPECT/CT for detecting renal oncocytoma versus (1) all other renal lesions and (2) chromophobe renal cell carcinoma (ChrRCC) alone.

Methods

A systematic review of MEDLINE, EMBASE, Scopus, the Cochrane Library, and the Gray Literature was performed. Original articles with > 5 patients evaluating oncocytomas versus other renal lesions with SPECT/CT using a pathological reference standard were included. Patient, clinical, imaging, and performance parameters were independently acquired by two reviewers. Meta-analysis was performed using a bivariate mixed-effects regression model.

Results

Four articles with a total of 117 renal lesions were included in analysis. The pooled and weighted sensitivity and specificity values of 99mTc-sestamibi SPECT/CT for detecting (1) renal oncocytoma versus other renal lesions were 92% (95% CI 72–98%) and 88% (95% CI 79–94%), respectively, and (2) 89% and 67%, respectively, for renal oncocytoma versus ChrRCC. The specificity for the detecting the oncocytoma-ChrRCC spectrum was 96% (95% CI 84–99%). The sensitivity and specificity for detecting benign versus malignant renal lesions were 86% (95% CI 66–95%) and 90% (95% CI 80–95%), and 88% and 95% when HOCTs were characterized as benign. All reporting studies used a cut-off tumor-to-background renal parenchyma radiotracer uptake ratio of > 0.6 for positive studies.

Conclusion

99mTc-sestamibi SPECT/CT demonstrates a high sensitivity and specificity for characterizing benign and low-grade renal lesions. This test can help improve the diagnostic confidence for patients with indeterminate renal masses being considered for active surveillance.

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Abbreviations

SPECT:

Single photon emission computed tomography

CT:

Computed tomography

ChrRCC:

Chromophobe renal cell carcinoma

QUADAS-2:

Quality Assessment of Diagnostic Accuracy Studies-2

HOCT:

Hybrid oncocytic/chromophobe tumors

RCC:

Renal cell carcinoma

AML:

Angiomyolipoma

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Funding

No funding was used for this review.

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Authors and Affiliations

  1. Department of Radiology and Diagnostic Imaging, University of Alberta, 2B2.41 WMC, 8440-112 Street NW, Edmonton, AB, T6G 2B7, Canada

    Mitchell P. Wilson, Prayash Katlariwala, Jonathan Abele & Gavin Low

  2. Evidence-based Practice Center, Mayo Clinic, Room 2-54, 205 3rd Ave SW, Rochester, MN, 55905, USA

    Mohammad H. Murad

  3. Departments of Radiology and Epidemiology, University of Ottawa/The Ottawa Hospital Research Institute, 01 Smyth Road, Box 232, Ottawa, ON, K1H-8L6, Canada

    Matthew D. F. McInnes

Authors
  1. Mitchell P. Wilson
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  2. Prayash Katlariwala
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  4. Jonathan Abele
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  5. Matthew D. F. McInnes
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  6. Gavin Low
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Contributions

MPW and GL conceptualized the study. MPW, JA, and GL contributed to study design. MPW performed the systematic search. MPW and PK performed the systematic review. MHM performed the meta-analysis. All authors contributed to data interpretation, write-up and editing of the final manuscript. All authors have approved the final manuscript.

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Correspondence to Mitchell P. Wilson.

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Wilson, M.P., Katlariwala, P., Murad, M.H. et al. Diagnostic accuracy of 99mTc-sestamibi SPECT/CT for detecting renal oncocytomas and other benign renal lesions: a systematic review and meta-analysis. Abdom Radiol 45, 2532–2541 (2020). https://doi.org/10.1007/s00261-020-02469-8

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  • DOI: https://doi.org/10.1007/s00261-020-02469-8

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