MIDOR – Molecular Imaging for Differential diagnosis of Oncocytoma from Renal Cell Carcioma

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When patients with Oncocytomas accurately can be identified pre-operatively, unnecessary surgery/treatment can be avoided.

Within Stockholm´s County and at Karolinska University hospital 250/ 120 patients are treated for suspected Renal Cell Carcinoma (RCC) annually. In a large majority of these cases the masses are post-operative found to be malignant and the patient benefit from the treatment. However the number of benign tumours, today often pre-operatively miss-classified as probable malignant is not negligible (5-20 percent). Oncocytoma is one of the most commonly occurring benign renal tumours and is today difficult to differentiate from RCC pre-operatively. This results in unnecessary and expensive treatment of a number of patients not benefitting from the procedure. The cost for a surgical resection for T1 A-B suspected RCC is estimated to 90 000-100 000 SEK.

Oncocytomas are unique tumour type in the ultrastactural level as these tumours are composed of cells with numerous densely packed mitochondria. A known mitochondrial imaging agent 99mTc-Sestamibi, has recently been used in studies including only a small number of patients with suspected RCC but with very promising results.

In this prospective study we will evaluate the diagnostic accuracy of gamma camera investigation with 99mTc-Sestamibi SPECT/CT in 180 patients with suspected RCC. Quantitative evaluation will be made with software developed by Hermes Medical Solutions and correlated to histopathology.

When patients with Oncocytomas accurately can be identified pre-operatively, unnecessary surgery/treatment can be avoided. In the long term this will result in avoiding suffering for patient not benefitting treatment, releasing treatment capacity to true RCC-patients. Unnecessary surgery can thus be avoided and costs can be reduced both for the health care system and the society as whole.

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MORE ABOUT THE PROJECT

Project leader Rimma Axelsson, Karolinska Universitetssjukhuset rimma.axelsson@ki.se
Funding from SWElife 1 898 665 SEK
Call for proposal SWElife spring 2015 call, for proposals for collaborative innovation projects within non-communicable diseases
About the project at Vinnova (in Swedish)