The role of molecular imaging in the characterization of renal masses

Purpose of review To explore the role of molecular imaging in the characterization of renal masses. Recent findings Incidentally detected renal masses exhibit variable malignant potential related to their underlying histology. Patients presenting with a renal mass should undergo individual risk stratification including characterization of their tumor histology. At the present time, anatomical imaging techniques are unable to reliably distinguish between the various renal tumor subtypes. Although renal mass biopsy is helpful in this regard, there are limitations of this procedure. Molecular imaging offers a noninvasive means of determining the histology of renal tumors. Imaging tests that have shown particular promise for this application include I-girentuximab PET/CT for diagnosing clear cell renal cell carcinoma and Tc-sestamibi SPECT/CT for diagnosing renal oncocytomas and hybrid oncocytic/chromophobe tumors. Summary Molecular imaging offers a noninvasive means of determining the histology of renal tumors thereby aiding in the risk stratification of patients presenting with a renal mass. Future work aims to develop a molecular imaging test that employs dual radiotracers allowing for the more precise characterization of renal tumors in a convenient single radiologic study.