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. 2025 Sep 23.
doi: 10.1007/s00259-025-07525-3. Online ahead of print.

[99mTc]Tc-sestamibi SPECT/CT for the diagnosis of kidney tumours: a multi-centre feasibility study (MULTI-MIBI Study)

Hannah Warren  1   2 , Thomas Wagner  3 , Soha El-Sheikh  4 , Nick Campain  5 , Tze M Wah  6 , Tim S O'Brien  7 , Iosif A Mendichovszky  8   9 , Sabina Dizdarevic  10   11 , Charlie Stewart  5 , Helen Ng  6 , James Blackmur  12 , Patrick Rogers  13 , Andrew Scarsbrook  6 , Dhruba Dasgupta  14 , Fahim Ul-Hassan  14 , Nitasha Singh  10 , Ammar Alanbuki  15 , Maryam Jessop  10 , Linda Park  5 , Kelly Leonard  12 , Alex Wood  13 , Ben Challacombe  7 , Grant D Stewart  16 , Ravi Barod  17   18 , Prasad Patki  18 , Faiz Mumtaz  17   18 , Axel Bex  17   18 , Veeru Kasivisvanathan  17 , William Wildgoose  19 , Sigrun Clark  20 , Cecilia Vindrola-Padros  20 , Elena Pizzo  21 , Hakim-Moulay Dehbi  22 , Mark Emberton  17 , Maxine Gb Tran  17   18
Affiliations
Free article

[99mTc]Tc-sestamibi SPECT/CT for the diagnosis of kidney tumours: a multi-centre feasibility study (MULTI-MIBI Study)

Hannah Warren et al. Eur J Nucl Med Mol Imaging. .
Free article

Abstract

Purpose: [99mTc]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.

Keywords: SPECT/CT; Diagnostic accuracy; Oncocytoma; Renal cancer; Sestamibi.

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Conflict of interest statement

Declarations. Ethics approval: This study was performed in line with the principles of the Declaration of Helsinki and Good Clinical Practice. Approval was granted by Sheffield Research Ethics Committee (UKHRA REC 20/YH/0279). Consent to participate: Informed consent was obtained from all individual participants included in the study. Consent to publish: The authors affirm that human research participants provided informed consent for publication of the images in Figs. 3 and 4. Competing interests: The authors have no relevant financial or non-financial interests to disclose.

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