Possible alternative to biopsy discovered for renal cancer diagnosis

By Lauretta Ihonor, medwireNews Reporter

Combining positron emission tomography (PET) scanning with iodine-124 (124I)-girentuximab may offer an effective noninvasive method of diagnosing clear cell renal cell carcinoma (ccRCC) in patients who present with a renal mass, US study results suggest.

This strategy "may be of value in risk stratification of patients with renal masses, and it fulfills an unmet medical need to improve appropriate patient care while minimizing the risks of invasive diagnostics and potentially unnecessary surgery," say the authors.

In the study of 195 patients, 124I-girentuximab plus PET or computed tomography (CT) identified the presence of ccRCC with a mean sensitivity of 86.2%, while use of the radioactive antibody in combination with contrast-enhanced CT (CECT) resulted in a significantly lower mean diagnostic sensitivity of 75.5%.

In addition, mean test specificity for ccRCC was significantly higher with 124I-girentuximab plus PET/CT than CECT, at 85.9% versus 46.8%.

As reported in the Journal of Clinical Oncology, the study participants, all of whom had unspecified renal masses, received intravenous 124I-girentuximab 2 to 6 days before undergoing PET/CT scan followed by CECT.

All underwent subsequent renal mass resection to provide samples for histological analysis that were used to definitively diagnose ccRCC in all patients.

Chaitanya Divgi (Columbia University Medical Center, New York) and colleagues report that there was a high level of agreement in the conclusions drawn by the three readers interpreting the scans, all of whom were blinded as to which diagnostic method was used.

Furthermore, 124I-girentuximab was well tolerated by all patients.

Divgi et al say: "This multicenter trial demonstrated that 124I-girentuximab PET/CT could provide information on the presence or absence of ccRCC with accuracy at least comparable to that of biopsy, while obviating the need for this procedure with its inherent risks."

They add that an accurate non-invasive method of diagnosing ccRCC may be of benefit to elderly or surgically fragile patients, or to those with comorbidities that make biopsy particularly unsuitable.

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