Conventional diagnostic strategies for imaging patients with renal cell carcinoma (RCC) have predominantly relied on ultrasonography, CT and MRI. However, a paradigm shift is underway with the emergence of several new radiotracers for molecular imaging. Carbonic anhydrase IX (CA-IX) imaging and sestamibi imaging can assist with identifying malignant renal tumours, whereas fluorodeoxyglucose, prostate-specific membrane antigen and CA-IX tracers can give guidance for diagnosis and staging of RCC. These tracers can assist in enabling better decision-making by minimising overtreatment of renal masses with biopsy, better selecting patients for curative-intented management and optimising treatment for patients with oligo-metastatic disease, among other emerging indications. However, none of them is yet recommended as a standard clinical diagnostic procedure. In this review, we investigate the latest developments in molecular imaging for detecting and staging RCC, aiming to advance precision diagnosis and improve patient outcomes.
BMJ oncology. 2025 Aug 17*** epublish ***
Jasmin Weindler, Muhammad Ali, Cristian Udovicich, Michael S Hofman, Shankar Siva
Prostate Cancer Theranostics and Imaging Centre of Excellence, Molecular Imaging and Therapeutic Nuclear Medicine, Cancer Imaging, Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia., Department of Radiation Oncology, Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia., Department of Radiation Oncology, GenesisCare, Melbourne, Victoria, Australia.