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Technetium-99m-sestamibi SPECT for the diagnosis
and follow-up of nasopharyngeal carcinoma |
| Jing CHEN MD1,Guang-Yuan HU MD2,Guo-Qing HU MD2,Hua WU PhD3, |
| 1.Department of Nuclear
Medicine, Tongji Hospital, Tongji Medical College, Huazhong University
of Science and Technology, Wuhan 430030, China; 2.Department of Oncology,
Tongji Hospital, Tongji Medical College, Huazhong University of Science
and Technology, Wuhan 430030, China; 3.Department of Nuclear
Medicine, Xiamen First Hospital, Fujian Medical University, Xiamen
361003, China; |
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Abstract This study was to investigate a better way to detect and differentiate primary, residual, recurrent nasopharyngeal carcinoma (NPC) lesions post-radiotherapy in patients with NPC by means of routine computed tomography (CT) in combination with 99Tcm-sestamibi single photon emission computed tomography (99Tcm-MIBI SPECT). Forty-eight patients with histologically confirmed primary NPC underwent 99Tcm-MIBI SPECT at the 3rd month before and after radiotherapy, and at the 6th month after radiotherapy. All patients had contemporaneous CT examinations. Histopathologic results and/or clinical follow-up data (over 18 months) were used as the golden standard for evaluating residual/recurrent lesions. The radioactive count ratio of nasopharynx to scalp was obtained as the MIBI uptake index (MUI). Receiver operating characteristic analysis was employed to define the cut-off value of MUI for malignancy. With MUI 2.15 as the cut-off point, the accuracy for detecting primary NPC was 94.12%. The mean MUI in the local-regional of the nasopharynx in such negative cases was 1.21±€0.12 at the 3rd month, while the mean MUI was higher in the other 15 patients with histologically confirmed recurrent/residual lesions (MUI=1.40€±€0.16, t=4.71, P<0.001). The optimal cut-off point of 1.33 of MUI was defined with 89.58% accuracy for differentiating residual/recurrent lesions from the benign process post radiotherapy, while CT evaluations showed an accuracy of 81.25%. A combination of CT and 99Tcm-MIBI SPECT for 37 NPC patients with congruent results showed an accuracy of 97.30% for differentiating residual/recurrent NPC from benign lesions. 99Tcm-MIBI SPECT plays a role in evaluating residual/recurrent lesions post-radiotherapy. The combination of CT and 99Tcm-MIBI SPECT can give more accurate diagnosis in the follow-up of NPC.
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| Keywords
nasopharyngeal carcinoma
diagnosis
follow-up
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Issue Date: 05 March 2010
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