|
|
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; |
|
|
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.
|
Keywords
nasopharyngeal carcinoma
diagnosis
follow-up
|
Issue Date: 05 March 2010
|
|
|
Chang E T, Adami H O. The enigmaticepidemiology of nasopharyngeal carcinoma. Cancer Epidemiol Biomakers Prev, 2006, 15(10): 1765―1777
doi: 10.1158/1055-9965.EPI-06-0353
|
|
Yu M C, Yuan J M. Epidemiologyof nasopharyngeal carcinoma. Semin CancerBiol, 2002, 12(6): 421―429
doi: 10.1016/S1044579X02000858
|
|
Abdulamir A S, Hafidh R R, Adbulmuhaimen N, Abubakar F, Abbas K A. The distinctiveprofile of risk factors of nasopharyngeal carcinoma in comparisonwith other head and neck cancer types. BMC Public Health, 2008, 5(8): 400
doi: 10.1186/1471-2458-8-400
|
|
Mcdermott A L, Dutt S N, Watkinson J C. The aetiology of nasopharyngealcarcinoma. Clin Otolarynqol Allied Sci, 2001, 26(2): 82―89
doi: 10.1046/j.1365-2273.2001.00449.x
|
|
Jeyakumar A, Brickman T M, Jeyakumar A, Doerr T. Review of nasopharyngeal carcinoma. Ear Nose Throat J, 2006, 85(3): 168―173
|
|
Guiqay J. Advances in nasopharyngeal carcinoma. Curr Opin Oncol, 2008, 20(3): 264―269
doi: 10.1097/CCO.0b013e3282fad846
|
|
Faivre S, Janot F, Armand J P. Optimal management of nasopharyngealcarcinoma. Curr Opin Oncol, 2004, 16(3): 231―235
doi: 10.1097/00001622-200405000-00007
|
|
Liu T, Xu W, Yan W L, Ye M, Bai Y R, Huang G. FDG-PET, CT, MRI for diagnosis of local residual or recurrentnasopharyngeal carcinoma, which one is the best? A systematic review. Radiother Oncol2007, 85(3): 327―335
doi: 10.1016/j.radonc.2007.11.002
|
|
Comoretto M, Balestreri L, Borsatti E, Cimitan M, Franchin G, Lise M. Detection and restaging ofresidual and/or recurrent nasopharyngeal carcinoma after chemotherapyand radiation therapy: comparison of MR imaging and FDG PET/CT. Radiology, 2008, 249(1): 203―211
doi: 10.1148/radiol.2491071753
|
|
Liu S H, Chang J T, Nq S H, Chan S C, Yen T C. False positive fluorine-18fluorodeoxy-D-glucose positron emission tomography finding causedby osteoradionecrosis in a nasopharyngeal carcinoma patient. Br J Radiol, 2004, 77(915): 257―260
doi: 10.1259/bjr/69516821
|
|
Kao C H, Shiau Y C, Shen Y Y, Yen R F. Detection of recurrent or persistent nasopharyngeal carcinomas afterradiotherapy with technetium-99m methoxyisobutylisonitrile singlephoton emission computed tomography and computed tomography: comparisonwith 18-fluoro-2-deoxyglucose positron emission tomography. Cancer, 2002, 94(7): 1981―1986
doi: 10.1002/cncr.10400
|
|
Kao C H, Tsai S C, Wang J J, Ho Y J, Yen R F, Ho S T. Comparing 18-fluoro-2-deoxyglucose positron emissiontomography with a combination of technetium 99m tetrofosmin singlephoton emission computed tomography and computed tomography to detectrecurrent or persistent nasopharyngeal carcinomas after radiotherapy. Cancer, 2001, 92(2): 434―439
doi: 10.1002/1097-0142(20010715)92:2<434::AID-CNCR1339>3.0.CO;2-O
|
|
Chan S C, Ng S H, Chang J T C, Lin C Y, Chang Y C, Hsu C L, Wang H M, Liao C T, Yen T C. Advantages and pitfalls of 18F-fluoro-2-deoxy-D-glucosepositron emission tomography in detecting locally residual or recurrentnasopharyngeal carcinoma: comparison with magnetic resonance imaging. Eur J Nucl Med Mol Imaging, 2006, 33(9): 1032―1040
doi: 10.1007/s00259-005-0054-6
|
|
Yen T C, Chang Y C, Chan S C, Chang J T, Hsu C H, Lin K J, Lin W J, Fu Y K, Nq S H. Are dual-phase 18F-FDG PET scans necessary in nasopharyngeal carcinomato assess the primary tumour and loco-regional nodes? Eur J Nucl Med Mol Imaging, 2005, 32(5): 541―548
doi: 10.1007/s00259-004-1719-2
|
|
Nq S H, Joseph C T, Chan S C, Ko S F, Wang H M, Liao C T, Chang Y C, Lin W J, Fu Y K, Yen T C. Clinical usefulness of 18F-FDGPET in nasopharyngeal carcinoma patients with questionable MRI findingsfor recurrence. J Nucl Med, 2004, 45(10): 1669―1676
|
|
Yen T C, Chang J T, Nq S H, Chang Y C, Chan S C, Lin K J, Lin W J, Fu Y K, Lin C Y. The value of 18F-FDG PET in the detection of stage M0 carcinoma ofthe nasopharynx. J Nucl Med, 2005, 46(3): 405―410
|
|
Yen R F, Hong R L, Tzen K Y, Pan M H, Chen T H. Whole-body 18F-FDG PET inrecurrent or metastatic nasopharyngeal carcinoma. J Nucl Med, 2005, 46(5): 770―774
|
|
Chen J, Wu H, Zhou J, Hu G Q. Using Tc-99m MIBI scintimammography to differentiate nodular lesionsin breast and detect axillary lymph node metastases from breast cancer. Chin Med J (Engl), 2003, 116(4): 620―640
|
|
Sato T, Kawabata Y, Iwashita Y, Suenaga S, Indo H, Hamahira S, Kawano K, Nitta T, Morita Y, Majima H, Sugihara K. Interpretation of scintigraphic findingsof oral malignant tumours with a new scanning agent of technetium-99m-hexakis-2-methoxy-isobutyl-isonitrile(Tc-99m-MIBI). Dentomaxillofac Radiol, 2006, 35(1): 24―29
doi: 10.1259/dmfr/96590988
|
|
Sato T, Kawabata Y, Kobayashi Y, Suenaqa S, Indo H, Kawano K, Iwashita Y, Morita Y, Majima H J. Scintigraphy for interpretation of malignant tumoursof the head and neck: comparison of technetium-99m-hexakis-2-methoxyisobutylisonitrile(Tc-MIBI) and thallium-201-chloride (Tl-201). Dentomaxillofac Radiol, 2005, 34(5): 268―273
doi: 10.1259/dmfr/65143191
|
|
Baldari S, Resifo Pecorella G, Cosentino S, Minutoli F. Investigation of brain tumours with (99m)Tc-MIBI SPET. Q J Nucl Med, 2002, 46(4): 336―345
|
|
Yamamoto Y, Nishiyama Y, Toyama Y, Kunishio K, Satoh K, Ohkawa M. 99mTc-MIBI and 201Tl SPET in the detectionof recurrent brain tumours after radiation therapy. Nucl Med Commun, 2002, 23(12): 1183―1190
doi: 10.1097/00006231-200212000-00006
|
|
Villa G, Balleari E, Carletto M, Grosso M, Clavio M, Piccardo A, Rebella L, Tommasi L, Morbelli S, Peschiera F, Gobbi M, Ghio R. Staging and therapy monitoring of multiple myeloma by99mTc-sestamibi scintigraphy: a five year single center experience. J Exp Clin Cancer Res, 2005, 24(3): 355―361
|
|
Svaldi M, Tappa C, Gebert U, Bettini D, Fabri P, Franzelin F, Osele L, Mitterer M. Technetium-99m-sestamibi scintigraphy:an alternative approach for diagnosis and follow-up of active myelomalesions after high-dose chemotherapy and autologous stem cell transplantation. Ann Hematol, 2001, 80(7): 393―397
doi: 10.1007/s002770100318
|
|
Myslivecek M, Nekula J, Bacovsky J, Scudla V, Koranda P, Kaminek M. Multiple myeloma: predictive value of Tc-99m MIBI scintigraphyand MRI in its diagnosis and therapy. NuclMed Rev Cent East Eur, 2008, 11(1): 12―16
|
|
Berberoglu K, Unal S N, Kebudi R, Turkmen C, Cantez S. Role of 99mTc-hexakis-2-methoxyisobutylisonitrilefor detecting marrow metastases in childhood solid tumours. Nucl Med Commun, 2005, 26(12): 1075―1080
doi: 10.1097/00006231-200512000-00005
|
|
Moustafa H, Riad R, Omar W, Zaher A, Ebied E. 99mTc-MIBI in the assessmentof response to chemotherapy and detection of recurrences in bone andsoft tissue tumours of the extremities. Q J Nucl Med, 2003, 47(1): 51―57
|
|
Pace L, Catalano L, Del Vecchio S, Di Gennaro F, De Renzo A, Sica G, Califano C, Tedesco N, Borrelli G, Rotoli B, Salvatore M. Predictive value of technetium-99m sestamibi in patients with multiplemyeloma and potential role in the follow-up. Eur J Nucl Med, 2001, 28(3): 304―312
doi: 10.1007/s002590000440
|
|
Yin H X, Ye W L. NasopharyngealCarcinoma. Beijing: China Union Medical University Press, 2002, 111
|
|
Du J Q, Yue D C, Pui M H, Zeng S Q, Ren Z G, Liu S H, Liu Z J. 99mTc-MIBIimaging in the follow-up of nasopharyngeal carcinomas. Zhong Hua He Yi Xue Za Zhi, 1998, 18(4): 238 (in Chinese)
|
|
Viewed |
|
|
|
Full text
|
|
|
|
|
Abstract
|
|
|
|
|
Cited |
|
|
|
|
|
Shared |
|
|
|
|
|
Discussed |
|
|
|
|