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The ZIRCON Trial

Panelists discuss how the ZIRCON trial demonstrated high positive predictive value (> 90%) for identifying clear cell renal cell carcinoma using a new molecular imaging agent, though negative predictive value was lower at approximately 70%.

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      The ZIRCON Trial and Molecular Imaging

      Main Discussion Topics:

      • The ZIRCON trial evaluated a novel PET tracer (89Zr-TLX250) for characterizing small renal masses.
      • The trial demonstrated high sensitivity and specificity for identifying clear cell renal cell carcinoma (ccRCC).
      • Positive predictive value exceeded 90% for ccRCC.
      • Negative predictive value was less impressive, with 30% still having ccRCC when test negative.

      Key Points for Physicians:

      • 89Zr-TLX250 PET showed greater than 85% accuracy for identifying ccRCC.
      • Positive predictive value of greater than 90% indicates high reliability when positive.
      • Negative predictive value was approximately 70%.
      • Represents entry into the “molecular era” of kidney cancer imaging

      Notable Insights:

      The high positive predictive value makes this a potentially valuable test when positive, though negative tests require careful interpretation.

      Clinical Significance:

      This molecular imaging approach represents a significant advance in noninvasive characterization of renal masses and may reduce unnecessary interventions.

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