99m Tc-MIBI scintigraphy for early detection of locally recurrent non-small cell lung cancer treated with definitive radiation therapy
| Autor: | Satoshi Natsui, Masaya Furuta, Miwako Nozaki, Yoshinori Kitazumi, Miho Kawashima, Koushuu Nagao, Mamoru Iimuro, Aya Okayama, Yoshio Hamashima |
|---|---|
| Rok vydání: | 2003 |
| Předmět: |
Male
Technetium Tc 99m Sestamibi medicine.medical_specialty Lung Neoplasms medicine.medical_treatment Radiography Scintigraphy Sensitivity and Specificity Fibrosis Carcinoma Non-Small-Cell Lung medicine Humans Radiology Nuclear Medicine and imaging Radionuclide Imaging Lung cancer Aged Lung medicine.diagnostic_test business.industry Reproducibility of Results Magnetic resonance imaging General Medicine Middle Aged medicine.disease Radiation therapy Treatment Outcome medicine.anatomical_structure Female Radiology Neoplasm Recurrence Local Radiopharmaceuticals Chest radiograph business Nuclear medicine |
| Zdroj: | European Journal of Nuclear Medicine and Molecular Imaging. 30:982-987 |
| ISSN: | 1619-7089 1619-7070 |
| DOI: | 10.1007/s00259-003-1188-z |
| Popis: | After radiation therapy of lung cancer, a dense fibrotic shadow develops in the irradiated lung. Owing to this fibrosis, early detection of local recurrence after treatment is sometimes difficult even when using computed tomography (CT) and magnetic resonance imaging. We investigated the diagnostic accuracy of technetium-99m hexakis 2-methoxyisobutylisonitrile ((99m)Tc-MIBI) scintigraphy for the detection of recurrent lung cancer following definitive radiation therapy. Eighteen patients with primary non-small cell lung cancer treated with radiation therapy 1 year previously were studied with (99m)Tc-MIBI scintigraphy. They showed no evidence of local recurrence on serial chest radiographs. All single-photon emission tomography (SPET) images acquired 2 h after intravenous administration of the radiopharmaceutical were visually interpreted with knowledge of the pretreatment chest radiograph, CT and the details of radiation therapy (radiation portals and administered doses). A region of interest (ROI) analysis was also performed. In addition to the ROI ratio of tumour uptake to accumulation in contralateral normal lung (tumour/lung ratio), another semiquantitative analysis, the ratio of tumour uptake to accumulation in radiation fibrosis (tumour/fibrosis ratio), was performed to differentiate between accumulation in radiation fibrosis and the tumour uptake. The scintigraphic diagnoses were correlated with clinical outcome. The sensitivity, specificity and negative predictive value of (99m)Tc-MIBI scintigraphy for the detection of recurrent lung cancer were all 88.9% (8/9). The tumour/lung ratios (mean+/-SEM) of the nine patients with local recurrence and the other eight without local failure were 2.00+/-0.11 and 1.40+/-0.09, respectively ( P0.01). The tumour/fibrosis ratios of the patients with and those without recurrence were 1.47+/-0.08 and 0.93+/-0.05, respectively ( P0.01). These results suggest that (99m)Tc-MIBI scintigraphy might be of value for the detection of recurrent lung cancer, and especially of small foci in areas of radiation fibrosis that are hardly noticeable on serial chest radiographs. |
| Databáze: | OpenAIRE |
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