Annals of Nuclear Medicine

, Volume 20, Issue 2, pp 107–114 | Cite as

Comparison of201Tl-chloride SPECT with99mTc-MIBI SPECT in the depiction of malignant head and neck tumors

  • Noriaki Tomura
  • Osamu Watanabe
  • Satoshi Takahashi
  • Ikuo Sakuma
  • Takahiro Otani
  • Toshiaki Nishii
  • Jiro Watarai
Original Article



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 words

head and neck neoplasms 201T1 chloride 99mTc MIBI SPECT 


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  1. 1.
    Fukumoto M. Single-photon agents for tumor imaging:201T1,99mTc-MIBI, and99mTc-tetrofosmin.Ann Nucl Med 2004; 18:79–95.PubMedCrossRefGoogle Scholar
  2. 2.
    Berk F, Demir H, Aktolun C. Thallium-201 imaging in the assessment of tumor response to anti-tumor treatments.Q J Nucl Med 2003; 47:63–74.PubMedGoogle Scholar
  3. 3.
    Mukherji SK, Gapany M, Phillips D, Neelon B, O’Brien S, McCartney W, et al. Thallium-201 single-photon emission CT versus CT for the detection of recurrent squamous cell carcinoma of the head and neck.AJNR 1999; 20:1215–1220.PubMedGoogle Scholar
  4. 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
  5. 5.
    Shiau YC, Liu FY, Huang WS, Yen RF, Kao CH. Using thallium-201 SPECT to detect recurrent or residual nasopharyngeal carcinoma after radiotherapy in patients with indeterminate CT findings.Head Neck 2003; 25:645–648.PubMedCrossRefGoogle Scholar
  6. 6.
    Shiau YC, Tsai SC, Ho YJ, Kao CH. Comparison of technetium-99m methoxyisobutylisonitrile single photon emission computed tomography and computed tomography to detect recurrent or residual nasopharyngeal carcinomas after radiotherapy.Anticancer Res 2001; 21:2213–2218.PubMedGoogle Scholar
  7. 7.
    Kao CH, Shiau YC, Shen YY, Yen RF. Detection of recurrent or persistent nasopharyngeal carcinomas after radiotherapy with technetium-99m methoxyisobutylisonitrile single photon emission computed tomography and computed tomography.Cancer 2002; 94:1981–1986.PubMedCrossRefGoogle Scholar
  8. 8.
    Nosotti M, Santambrogio L, Gasparini M, Baisi A, Bellaviti N, Rosso L. Role of99mTc-hexakis-2-methoxyisobutyl- isonitrile in the diagnosis and staging of lung cancer.Chest 2002; 122:1361–1364.PubMedCrossRefGoogle Scholar
  9. 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
  10. 10.
    Kim SJ, Kim IJ, Bae YT, Kim YK, Kim DS. Incremental diagnostic value of quantitative analysis of double phase Tc-99m MIBI scintimammography for the detection of primary breast cancer additive to visual analysis.Breast Cancer Res Treat 2004; 83:129–138.PubMedCrossRefGoogle Scholar
  11. 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
  12. 12.
    Jeune FPL, Dubois F, Perez S, Blond S, Steinling M. Technetium-99m sestamibi brain SPECT in the follow-up of glioma for evaluation of response to chemotherapy: first results.Eur J Nucl Med Mol Imaging 2004; 31:714–719.CrossRefGoogle Scholar
  13. 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. 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
  15. 15.
    McGuirt WF, Greven K, Williams D 3rd, Keyes JW Jr, Watson N, Cappellari JO. PET scanning in head and neck oncology: a review.Head Neck 1998; 20:208–215.PubMedCrossRefGoogle Scholar
  16. 16.
    Tomura N, Hirano H, Watanabe O, Hirano Y, Kato K, Sasaki K, et al. Comparison of thallium-201 and gallium-67 imaging in evaluation of head and neck tumors.J Comput Assist Tomogr 2000; 24:454–460.PubMedCrossRefGoogle Scholar
  17. 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
  18. 18.
    Nishiyama Y, Yamamoto Y, Fukunaga K, Satoh K, Kunishio K, Ohkawa M. Comparison of99Tcm-MIBI with20lTl chloride SPET in patients with malignant brain tumours.Nucl Med Commun 2001; 22:631–639.PubMedCrossRefGoogle Scholar
  19. 19.
    Yamamoto Y, Nishiyama Y, Toyama Y, Kunishio K, Satoh K, Ohkawa M.99mTc-MIBI and201Tl SPET in the detection of recurrent brain tumours after radiation therapy.Nucl Med Commun 2002; 23:1183–1190.PubMedCrossRefGoogle Scholar
  20. 20.
    O’Tuama LA, Treves ST, Larar JN, Packard AB, Kwan AJ, Barnes PD, et al. Thallium-201 versus technetium-99m-MIBI SPECT in evaluation of childhood brain tumors: a within-subject comparison.J Nucl Med 1993; 34:1045–1051.PubMedGoogle Scholar
  21. 21.
    Wang SJ, Hsu CY, Lin WY, Kao CH, Jan JS, Yeh SH. Comparison of Tl-201 and Tc-99m MIBI SPECT imaging in nasopharyngeal carcinoma.Clin Nucl Med 1995; 20:800–802.PubMedCrossRefGoogle Scholar
  22. 22.
    Henze M, Mohammed A, Mier W, Rudat V, Dietz A, Nollert J, et al. Pretreatment evaluation of carcinomas of the hypopharynx and larynx withl8F-fluorodeoxyglucose,123I- α-methyl-L-tyrosine and99mTc-hexakis-2-methoxyiso- butylisonitrile.Eur J Nucl Med 2002; 29:324–330.CrossRefGoogle Scholar

Copyright information

© Springer 2006

Authors and Affiliations

  • Noriaki Tomura
    • 1
  • Osamu Watanabe
    • 1
  • Satoshi Takahashi
    • 1
  • Ikuo Sakuma
    • 1
  • Takahiro Otani
    • 1
  • Toshiaki Nishii
    • 1
  • Jiro Watarai
    • 1
  1. 1.Department of RadiologyAkita University School of MedicineAkitaJAPAN

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