title: Initial experience using 99mTc-MIBI SPECT/CT for the differentiation of oncocytoma from renal cell carcinoma.
abstract: OBJECTIVE
  The differentiation of oncocytoma from renal cell carcinoma (RCC) remains a challenge with currently available cross-sectional imaging techniques. As a result, a large number of patients harboring a benign oncocytoma undergo unnecessary surgical resection. In this study, we explored the utility of 99mTc-MIBI SPECT/CT for the differentiation of these tumors based on the hypothesis that the large number of mitochondria in oncocytomas would lead to increased 99mTc-MIBI uptake.
  
  
  METHODS
  In total, 6 patients (3 with oncocytoma and 3 with RCC) were imaged with 99mTc-MIBI SPECT/CT. Relative quantification was performed by measuring tumor-to-normal renal parenchyma background ratios.
  
  
  RESULTS
  All 3 oncocytomas demonstrated radiotracer uptake near or above the normal renal parenchymal uptake (range of uptake ratios, 0.85-1.78). In contrast, the 3 RCCs were profoundly photopenic relative to renal background (range of uptake ratios, 0.21-0.31).
  
  
  CONCLUSIONS
  99mTc-MIBI SPECT/CT appears to be of value in scintigraphically distinguishing benign renal oncocytoma from RCC.
authors.affiliation: From the *The Russell H. Morgan Department of Radiology and Radiological Science, †The James Buchanan Brady Urological Institute and Department of Urology, and ‡Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, MD; and §Department of Nuclear Medicine, University of Würzburg, Würzburg, Germany.
authors.forename: Steven P
authors.initials: SP
authors.lastname: Rowe
authors.forename: Michael A
authors.initials: MA
authors.lastname: Gorin
authors.forename: Jennifer
authors.initials: J
authors.lastname: Gordetsky
authors.forename: Mark W
authors.initials: MW
authors.lastname: Ball
authors.forename: Phillip M
authors.initials: PM
authors.lastname: Pierorazio
authors.forename: Takahiro
authors.initials: T
authors.lastname: Higuchi
authors.forename: Jonathan I
authors.initials: JI
authors.lastname: Epstein
authors.forename: Mohamad E
authors.initials: ME
authors.lastname: Allaf
authors.forename: Mehrbod S
authors.initials: MS
authors.lastname: Javadi
mesh_terms: D018249:Adenoma, Oxyphilic / Q000000981:diagnostic imaging*; D000328:Adult; D000368:Aged; D002292:Carcinoma, Renal Cell / Q000000981:diagnostic imaging*; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D007680:Kidney Neoplasms / Q000000981:diagnostic imaging*; D008297:Male; D008875:Middle Aged; D064847:Multimodal Imaging; D019275:Radiopharmaceuticals; D017256:Technetium Tc 99m Sestamibi; D015899:Tomography, Emission-Computed, Single-Photon; D014057:Tomography, X-Ray Computed
chemical_list: D019275:Radiopharmaceuticals; D017256:Technetium Tc 99m Sestamibi