Novel radiopharmaceuticals for molecular imaging of renal cell carcinoma

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.