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Clinical CA9\u2010targeted PET imaging is evaluated in patients with renal masses and examined alongside\n                      <jats:sup>18<\/jats:sup>\n                      F\u2010FDG PET.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>CA9 is preferentially enriched in ccRCC tumor cells with low background expression in normal kidney tissue. CA9\u2010targeted PET imaging shows potential for noninvasive discrimination of ccRCC from nccRCC, including lesions with distinct histologies within individual patients. High CA9\u2010targeted PET uptake is associated with PBRM1 loss\u2010of\u2010function alterations, immune pathway suppression with reduced B cell infiltration, metabolic alterations, and enhanced angiogenic activity. Single\u2010cell and spatial analyses support endothelial enrichment and angiogenesis\u2010associated programs in CA9\u2010high regions. CA9\u2010high PDX models showed greater tumor growth inhibition under axitinib treatment.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>CA9\u2010targeted PET provides proof\u2010of\u2010concept evidence for noninvasive discrimination of ccRCC and associated angiogenic and tumor biological features, warranting prospective validation.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/advs.76622","type":"journal-article","created":{"date-parts":[[2026,7,20]],"date-time":"2026-07-20T11:32:27Z","timestamp":1784547147000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["CA9\u2010Targeted PET Imaging for Noninvasive Discrimination of Clear Cell Renal Cell Carcinoma and Associated Tumor Biological 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