[99mTc]Tc-sestamibi SPECT/CT for the diagnosis of kidney tumours: a multi-centre feasibility study (MULTI-MIBI Study)
Year: 2025
Type: article
Study design: Observational Study
Abstract: PURPOSE: Tc]Tc-sestamibi SPECT/CT (MIBI SPECT/CT) is a promising tool to differentiate benign and malignant renal tumours. We tested feasibility of recruitment to a prospective, multi-centre diagnostic test evaluation study of MIBI SPECT/CT for T1 renal tumours. METHODS: Consecutive adult patients with a newly-diagnosed clinical T1 (cT1) renal mass (2-7 cm) presenting to participating sites December 2022 - February 2024 were recruited and underwent MIBI SPECT/CT prior to histopathological diagnosis. Patients who accepted and declined participation and clinicians involved in study activities were invited to a semi-structured interview. The primary endpoint was feasibility of multi-centre recruitment. Secondary endpoints included qualitative assessment of barriers and facilitators to participation, estimates of MIBI SPECT/CT accuracy to detect cancer in order to power a definitive study, inter-rater agreement and identifying training needs for scan acquisition and interpretation. RESULTS: Of 109 approached patients, 50 enrolled and underwent the study scan (45.8%, 95% CI 36.2-55.7%) across 6 sites. MIBI SPECT/CT scans were acquired and reported without the need for significant additional training. All scans were of adequate quality for interpretation. Sensitivity and specificity of MIBI SPECT/CT to detect cancer were 97.0% (95% CI 84.2-99.9%) and 53.8% (25.1-80.8%), respectively. CONCLUSION: MULTI-MIBI has demonstrated feasibility of recruitment to a diagnostic evaluation study for T1 renal masses. Preliminary estimates of diagnostic accuracy suggest that MIBI SPECT/CT could reduce the number of patients with benign tumours undergoing surgery without missing a significant number of patients with malignant disease, however these results are limited by the small sample size in this feasibility study and a larger definitive study is needed prior to adoption in practice.
Authors: Hannah Warren, Thomas Wagner, Soha El-Sheikh, Nick Campain, Tze M. Wah, Tim S. O’Brien, Iosif A. Mendichovszky, Sabina Dizdarevic, Charlie Stewart, Helen Ng, James Blackmur, Patrick Rogers, Andrew Scarsbrook, Dhruba Dasgupta, Fahim Ul-Hassan, Nitasha Singh, Ammar Alanbuki, Maryam Jessop, Linda Park, Kelly Leonard, Alex Wood, Ben Challacombe, Grant D. Stewart, Ravi Barod, Prasad Patki, Faiz Mumtaz, Axel Bex, Veeru Kasivisvanathan, William Wildgoose, Sigrun Clark, Cecilia Vindrola-Padros, Elena Pizzo, Hakim-Moulay Dehbi, Mark Emberton, Maxine GB Tran
Institutions: The Royal Free Hospital, University College London, Royal Devon & Exeter NHS Foundation Trust, Royal Devon University Healthcare NHS Foundation Trust, Leeds Teaching Hospitals NHS Trust, Guy's and St Thomas' NHS Foundation Trust, University of Cambridge, Cambridge University Hospitals NHS Foundation Trust, Brighton and Sussex Medical School, University Hospitals Sussex NHS Foundation Trust, MRC Clinical Trials Unit at UCL
Language: English
Subfield: Radiology, Nuclear Medicine and Imaging
Field: Medicine
Domain: Health Sciences
Open Access status: hybrid
Estimated APC paid: $3,490
OpenAlex ID: W4414448038