Comparison of201Tl-chloride SPECT with99mTc-MIBI SPECT in the depiction of malignant head and neck tumors
Comparison of201T1 chloride SPECT (Tl-SPECT) with99mTc-MIBI SPECT (MIBI-SPECT) in the depiction of malignant head and neck tumors was prospectively studied.
Forty-one patients with various tumors of the head and neck were included in this prospective study. Histologically, 36 patients had squamous cell carcinomas, 3 undifferentiated carcinomas, 1 transitional cell carcinoma, and 1 MALT lymphoma. All patients underwent a simultaneous dual-isotope SPECT of the head and neck with201Tl and99mTc-MIBI. Dual-isotope SPECT for early (n = 41) and delayed acquisition (n = 21) was performed. Qualitatively, 3 observers evaluated both Tl-SPECT and MIBI-SPECT individually. The interpretation criteria were graded as grade 1 (no abnormal increased uptake) to 5 (definitely increased uptake of a degree equal to or greater than that of normal salivary gland). Statistical analysis of the comparison of Tl-SPECT and MIBI-SPECT was performed. The interobserver difference was evaluated using the κ-coefficient. Quantitatively, T/N ratio (the ratio of the counts in the tumor divided by that in the normal nuchal muscles) and retention index were compared between Tl-SPECT and MIBI-SPECT.
On both the early and delayed images, the grades of uptake of the tumor in Tl-SPECT were significantly higher than those in MIBI-SPECT by three observers. The grade of T1-uptake of the tumor on the delayed images was 5 for all observers (κ-coefficient =1); however, the κ-coefficient varied from 0.39 to 0.84 in early Tl-SPECT, and in early and delayed MIBI-SPECT. Statistical differences in T/N ratio were noted between early Tl-SPECT (2.87 ± 1.19) and MIBI-SPECT (2.48 ± 1.06), and between delayed Tl-SPECT (2.11 ± 0.70) and MIBI-SPECT ( 1.20 ± 0.48). The retention index of Tl-SPECT (0.81 ± 0.24) was significantly higher than that of MIBI-SPECT (0.52 ± 0.15).
The present study qualitatively and quantitatively showed that201T1 had higher accumulation in the tumor than99mTc-MIBI in both early and delayed images.
Key wordshead and neck neoplasms 201T1 chloride 99mTc MIBI SPECT
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- 4.Tai CJ, Liang JA, Yang SN, Tsai MH, Lin CC, Kao CH. Detection of recurrent nasopharyngeal carcinomas with thallium-201 single-photon emission computed tomography in patients with indeterminate magnetic resonance imaging findings after radiotherapy.Head Neck 2003; 25:227–231.PubMedCrossRefGoogle Scholar
- 9.Tsai MH, Shiau YC, Tai CJ, Lin CC, Lee CC, Kao A. Detection of recurrent nasopharyngeal carcinomas with technetium-99m methoxyisobutylisonitrile single photon emission computed tomography in patients with indeterminate magnetic resonance imaging findings after radiotherapy.Ann Otol Rhinol Laryngol 2003; 112:415–418.PubMedGoogle Scholar
- 11.Fuster D, Vinolas N, Mallafre C, Pavia J, Martin F, Pons F. Tetrofosmin as predictor of tumour response.G J Nucl Med 2003; 47:58–62.Google Scholar
- 13.Sobin LH, Wittekind Ch.UICC international union against cancer. TNM classification of malignant tumours.6th ed. New York; Wiley-Liss, 2002.Google Scholar
- 14.Tomura N, Kobayashi M, Oyama Y, Satoh K, Kato K, Kusaka K, et al. Thallium-201 single photon emission computed tomography in the evaluation of therapeutic response for brain tumors.KAKU IGAKU (Jpn J Nucl Med) 1994; 31:951–956.Google Scholar
- 17.Tomura N, Hirano H, Watanabe O, Kato K, Sasaki K, Watarai J, et al. Preliminary results with technetium-99m MIBI SPECT imaging in patients with brain tumors: correlation with histological and neuroradiological diagnosis and therapeutic response.Comput Med Imaging Graph 1997; 21:293–298.PubMedCrossRefGoogle Scholar