A single photon emission computed tomography (SPECT) with201Tl chloride (Tl-201) was carried out prospectively in 50 patients with pulmonary nodules and its diagnostic value was compared with those of67Ga citrate (Ga-67) and99mTc-labeled hexamethyl-propyleneamineoxime (Tc-99m-HMPAO). Tl-201 SPECT provided 88% (early)–91% (delayed) sensitivity, 85% (early and delayed) specificity and 87% (early)–89% (delayed) accuracy. The sensitivity of the Tl-201 planar image was 56 (early)–62% (delayed), which was significantly lower than that of SPECT. Delayed SPECT images at 2 hour postinjection were more preferable to disclose the malignant pulmonary nodule than early SPECT images at 15 minutes postinjection. The application of SPECT with Ga-67 failed to improve the sensitivity of planar imaging for malignant pulmonary nodules. Tc-99m-HMPAO was concentrated in 62% of 13 patients with malignant pulmonary nodules, which was slightly higher than Ga-67 in 54% of 28 patients. In an analysis of the histologic types of lung cancer, the sensitivity of Tl-201 was not significantly different in all types. On the other hand, Ga-67 was positive only in 25% of 12 patients with adenocarcinoma.
A combination of SPECT and Tl-201 is the best choice among routine scintigraphic techniques for depicting malignant pulmonary nodules. The Tl-201 SPECT image may play a complementary role in the characterization of pulmonary nodules which are revealed on a plain radiograph and computed tomography.
single photon emission computed tomography (SPECT) 201T1 chloride 67Ga citrate 99mTc-hexamethyl-propyleneamine-oxime lung cancer
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Itoh K: Tumor scintigraphy in lung and mediastinum. In: Hisada K, Furudate M, Sasaki Y eds:A new textbook of clinical nuclear medicine (1st ed.). Tokyo, kanehara Shuppan, pp 241–242, 1986 (in Japanese)Google Scholar
Coleman RE: Single photon emission computed tomography and positron emission tomography in cancer imaging.Cancer 67 (suppl. 15): 1261–1270, 1991.PubMedCrossRefGoogle Scholar
Tonami N, Shuke N, Yokoyama K, et al: Thallium-201 single photon emission computed tomography in the evaluation of suspected lung cancer.J Nucl Med 30: 997–1004, 1989PubMedGoogle Scholar
Tonami N, Hisada K, Watanabe Y, et al:201Tl single photon emission computed tomography in the diagnosis of lung cancer.Rinshyo Hoshyasen 35: 825–832, 1990 (in Japanese)Google Scholar
Sessler MJ, Geek P, Maul FD, et al: New aspects of cellular thallium uptake: Tl, Na, Cl co transport is the central mechanism of ion uptake.Nuklearmedizin 25: 24–27, 1986PubMedGoogle Scholar
Tonami N, Hisada K: Clinical experience of tumor imaging with Tl-201-chloride.Clin Nucl Med 2: 75–81, 1977CrossRefGoogle Scholar
Itoh K: Study on localization of hyperfunctioning parathyroid glands by99Tl-99mTc subtraction scintigraphy.Hokkaido Igakuzashi 59: 701–720, 1984 (in Japanese)Google Scholar
Winzelberg GG, Hyvovitz JD: Radionuclide imaging of parathyroid tumors: historical perspectives and newer techniques.Semin Nucl Med 15: 161–169 1985PubMedCrossRefGoogle Scholar
Kaplan WD, Takvorian T, Morris JH, et al: Thallium-201 brain imaging: a comparative study with pathologic correlation.J Nucl Med 28:47–52, 1987PubMedGoogle Scholar
Neirinckx RD, Canning LR, Piper IM, et al: Technetium-99m d,l-HM-PAO: a new radiopharmaceutical for SPECT imaging of regional cerebral blood perfusion.J Nucl Med 28: 191–202, 1987PubMedGoogle Scholar
Irvine AT, Flower MA, Ott RJ, et al: An evaluation of99mTc-HMPAO uptake in cerebral gliomas—a comparison with X-ray CT.Eur J Nucl Med 16: 293–298, 1990PubMedCrossRefGoogle Scholar
Oshima M, Itoh K, Okae S, et al: Evaluation of primary lung carcinoma using technetium 99m-hexamethylpropylene amine oxime: preliminary clinical experience.Eur J Nucl Med 16: 859–864, 1990PubMedCrossRefGoogle Scholar
Lebowitz E, Greene MW, Fairchild R, et al: Thallium-201 for medical use. I.J Nucl Med 16: 151–155, 1975PubMedGoogle Scholar
Bradley-Moore PR, Lebowitz E, Greene MW, et al: Thallium-201 for medical use. II: biologic behavior.J Nucl Med 16: 156–160, 1975PubMedGoogle Scholar
Ando A, Ando I, Katayama M, et al: Biodistributions of Tl-201 in tumor bearing animals and inflammatory lesions induced in animals.Eur J Nucl Med 12: 567–572, 1987PubMedCrossRefGoogle Scholar
Shin W-J, Magoun S, Stopp V, et al: Thallium-201-chloride lung imaging for bronchogenic carcinoma.J Nucl Med Tech 2: 83–86, 1991Google Scholar