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Volume 63, Issue 6, Pages 1101-1106 (June 2013) Indium-111–labeled Girentuximab ImmunoSPECT as a Diagnostic Tool in Clear Cell Renal Cell Carcinoma Constantijn H.J. Muselaers, Otto C. Boerman, Egbert Oosterwijk, Johannes F. Langenhuijsen, Wim J.G. Oyen, Peter F.A. Mulders European Urology Volume 63, Issue 6, Pages 1101-1106 (June 2013) DOI: 10.1016/j.eururo.2013.02.022 Copyright © 2013 European Association of Urology Terms and Conditions

Fig. 1 Posterior 111In-girentuximab image of Patient 14 with a small renal mass in the left kidney. An attempt to biopsy the lesion had failed and the patient underwent 111In-girentuximab immunoSPECT. Besides normal uptake in the right upper abdomen (liver and upper gastrointestinal tract), clear targeting of 111In-girentuximab is seen in lesion (arrow). Histopathologic examination revealed a clear cell renal cell carcinoma with a 12-mm diameter. European Urology 2013 63, 1101-1106DOI: (10.1016/j.eururo.2013.02.022) Copyright © 2013 European Association of Urology Terms and Conditions

Fig. 2 Carbonic anhydrase IX (CAIX) expression in a type 2 papillary tumor. CAIX expression was found in a vital tumor region within a necrotic part of the surgical specimen, suggesting hypoxia-driven expression. European Urology 2013 63, 1101-1106DOI: (10.1016/j.eururo.2013.02.022) Copyright © 2013 European Association of Urology Terms and Conditions

Fig. 3 Images from Patient 29, who had a history of clear cell renal cell carcinoma. After tumor nephrectomy, the patient entered active surveillance. (a) On follow-up computed tomography (CT) scan, a 5-mm lesion in segment 8 of the liver was detected, and biopsy of this lesion was nonconclusive. (b) Clear targeting of the liver lesion on the subsequent 111In-girentuximab immunoSPECT was detected. (c) On a follow-up CT scan 2 mo after immunoSPECT, growth of the lesion was detected and systemic therapy was started. European Urology 2013 63, 1101-1106DOI: (10.1016/j.eururo.2013.02.022) Copyright © 2013 European Association of Urology Terms and Conditions