DMSA-SPECT: A Novel Approach to Nephron Sparing SBRT for Renal Cell Carcinoma

Neil Chevli; Stephen Chiang; Andrew M. Farach; Waqar Haque; Raj Satkunasivam; Eric H. Bernicker; Ramiro Pino; Edward Brian Butler; Bin S. Teh

doi:10.1016/j.adro.2021.100719

DMSA-SPECT: A Novel Approach to Nephron Sparing SBRT for Renal Cell Carcinoma

Neil Chevli, Stephen Chiang, Andrew M. Farach, Waqar Haque, Raj Satkunasivam, Eric H. Bernicker, Ramiro Pino, Edward Brian Butler, Bin S. Teh

Research output: Contribution to journal › Article › peer-review

4 Scopus citations

Abstract

Purpose: Stereotactic body radiation therapy (SBRT) treatment planning for renal cell carcinoma requires accurate delineation of tumor from normal tissue due to the radiosensitivity of normal renal cortical tissue. Tc-99m dimercapto succinic acid (DMSA) renal imaging is a functional imaging technique that precisely differentiates normal renal cortical tissue from tumor. There are no prior publications reporting using this imaging modality for SBRT treatment planning. Methods and Materials: A 59-year-old female with stage IV renal cell carcinoma progressed on systemic therapy and was dispositioned to primary cytoreduction with SBRT. She had baseline renal dysfunction and her tumor was 9 cm without clear delineation from normal tissue on conventional imaging. DMSA-single-photon emission computerized tomography (SPECT)/computed tomography (CT) was used for treatment planning. Results: DMSA-SPECT/CT precisely delineated normal renal cortical tissue from tumor. Three months after treatment, labs were stable and DMSA-SPECT/CT was unchanged. The treated lesion had markedly decreased positron emission tomography avidity. Conclusions: DMSA-SPECT or SPECT/CT can be incorporated into radiation therapy planning for renal lesions to improve target delineation and better preserve renal function.

Original language	English (US)
Article number	100719
Journal	Advances in Radiation Oncology
Volume	6
Issue number	6
DOIs	https://doi.org/10.1016/j.adro.2021.100719 https://doi.org/10.1016/j.adro.2021.100719
State	Published - Nov 1 2021

ASJC Scopus subject areas

Oncology
Radiology Nuclear Medicine and imaging

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@article{ef1c8a766d6f4da588c487960f8de830,

title = "DMSA-SPECT: A Novel Approach to Nephron Sparing SBRT for Renal Cell Carcinoma",

abstract = "Purpose: Stereotactic body radiation therapy (SBRT) treatment planning for renal cell carcinoma requires accurate delineation of tumor from normal tissue due to the radiosensitivity of normal renal cortical tissue. Tc-99m dimercapto succinic acid (DMSA) renal imaging is a functional imaging technique that precisely differentiates normal renal cortical tissue from tumor. There are no prior publications reporting using this imaging modality for SBRT treatment planning. Methods and Materials: A 59-year-old female with stage IV renal cell carcinoma progressed on systemic therapy and was dispositioned to primary cytoreduction with SBRT. She had baseline renal dysfunction and her tumor was 9 cm without clear delineation from normal tissue on conventional imaging. DMSA-single-photon emission computerized tomography (SPECT)/computed tomography (CT) was used for treatment planning. Results: DMSA-SPECT/CT precisely delineated normal renal cortical tissue from tumor. Three months after treatment, labs were stable and DMSA-SPECT/CT was unchanged. The treated lesion had markedly decreased positron emission tomography avidity. Conclusions: DMSA-SPECT or SPECT/CT can be incorporated into radiation therapy planning for renal lesions to improve target delineation and better preserve renal function.",

author = "Neil Chevli and Stephen Chiang and Farach, {Andrew M.} and Waqar Haque and Raj Satkunasivam and Bernicker, {Eric H.} and Ramiro Pino and Butler, {Edward Brian} and Teh, {Bin S.}",

note = "Funding Information: Sources of support: This work had no specific funding. Publisher Copyright: {\textcopyright} 2021 The Author(s)",

year = "2021",

month = nov,

day = "1",

doi = "10.1016/j.adro.2021.100719",

language = "English (US)",

volume = "6",

journal = "Advances in Radiation Oncology",

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T1 - DMSA-SPECT

T2 - A Novel Approach to Nephron Sparing SBRT for Renal Cell Carcinoma

AU - Chevli, Neil

AU - Chiang, Stephen

AU - Farach, Andrew M.

AU - Haque, Waqar

AU - Satkunasivam, Raj

AU - Bernicker, Eric H.

AU - Pino, Ramiro

AU - Butler, Edward Brian

AU - Teh, Bin S.

PY - 2021/11/1

Y1 - 2021/11/1

N2 - Purpose: Stereotactic body radiation therapy (SBRT) treatment planning for renal cell carcinoma requires accurate delineation of tumor from normal tissue due to the radiosensitivity of normal renal cortical tissue. Tc-99m dimercapto succinic acid (DMSA) renal imaging is a functional imaging technique that precisely differentiates normal renal cortical tissue from tumor. There are no prior publications reporting using this imaging modality for SBRT treatment planning. Methods and Materials: A 59-year-old female with stage IV renal cell carcinoma progressed on systemic therapy and was dispositioned to primary cytoreduction with SBRT. She had baseline renal dysfunction and her tumor was 9 cm without clear delineation from normal tissue on conventional imaging. DMSA-single-photon emission computerized tomography (SPECT)/computed tomography (CT) was used for treatment planning. Results: DMSA-SPECT/CT precisely delineated normal renal cortical tissue from tumor. Three months after treatment, labs were stable and DMSA-SPECT/CT was unchanged. The treated lesion had markedly decreased positron emission tomography avidity. Conclusions: DMSA-SPECT or SPECT/CT can be incorporated into radiation therapy planning for renal lesions to improve target delineation and better preserve renal function.

AB - Purpose: Stereotactic body radiation therapy (SBRT) treatment planning for renal cell carcinoma requires accurate delineation of tumor from normal tissue due to the radiosensitivity of normal renal cortical tissue. Tc-99m dimercapto succinic acid (DMSA) renal imaging is a functional imaging technique that precisely differentiates normal renal cortical tissue from tumor. There are no prior publications reporting using this imaging modality for SBRT treatment planning. Methods and Materials: A 59-year-old female with stage IV renal cell carcinoma progressed on systemic therapy and was dispositioned to primary cytoreduction with SBRT. She had baseline renal dysfunction and her tumor was 9 cm without clear delineation from normal tissue on conventional imaging. DMSA-single-photon emission computerized tomography (SPECT)/computed tomography (CT) was used for treatment planning. Results: DMSA-SPECT/CT precisely delineated normal renal cortical tissue from tumor. Three months after treatment, labs were stable and DMSA-SPECT/CT was unchanged. The treated lesion had markedly decreased positron emission tomography avidity. Conclusions: DMSA-SPECT or SPECT/CT can be incorporated into radiation therapy planning for renal lesions to improve target delineation and better preserve renal function.

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DMSA-SPECT: A Novel Approach to Nephron Sparing SBRT for Renal Cell Carcinoma

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