How to avoid unnecessary renal surgery

MIDOR – Molecular Imaging for Differential Diagnosis of Oncocytoma from Renal Carcinoma

How to avoid unnecessary renal surgery

“By then, the patient has undergone difficult surgery with anaesthesia, possible side-effects and sick leave. Furthermore, each operation costs the healthcare sector SEK 100 000. With this method, we can avoid that”, says Professor Rimma Axelsson.

The major difficulty today of distinguishing between benign renal tumours and cancer which requires surgical removal, is that there are no reliable imaging methods. The team, which includes Rimma Axelsson and software developer Hermes Medical Solutions, is currently working on a method – MIDOR – to enable preoperative diagnostics with a high level of certainty.

Software is key

“The starting point is a common and established biomarker, used in cardiovascular examinations for the past 20 years, as well as a gamma camera. The marker illuminates the benign tumour cells. What makes it unique is the combination with the new software, which can quantify that which is not visible to the human eye. We aim to find a quantitative measurement with which it will be possible to determine accurately which tumours the surgeons do not have to remove solely as a safety precaution”, says Axelsson.

The market is global:

“Renal tumours affect many people all over the world, and everywhere you encounter the same problem: only after surgery is it possible to tell whether or not it was necessary.”

The team has conducted a pilot study of 28 patients. In 12 of them, the tumour was benign, and in 11 of these, the results were detected by MIDOR.

Although this means that, in real-life situations, 11 completely unnecessary operations could have been avoided, Rimma Axelsson and her team colleagues obviously also want to find the 12th. Therefore, work is now underway to refine the method.

A growing interest

The unique component of the method is the software, and as Rimma Axelsson’s team continues to presents its results, the interest in the product increases. Johns Hopkins University Hospital in the US has recently purchased the software from Hermes and wants to initiate a collaboration with Axelsson’s team.

“This year, we will write our recommendations concerning MIDOR and these will be presented at a national meeting for urologists and surgeons”, says Rimma Axelsson. “Then, more people can decide to follow our lead and invest in the software in order to be able to perform examinations with a high level of accuracy.”

Updated: 16 June 2017

Text: Jörgen Olsson