Diagnostic Performances of 99mTc-Methoxy Isobutyl Isonitrile Scan in Predicting the Malignancy of Lung Lesions

Abstract

We performed a meta-analysis to evaluate the value of technetium-99m methoxy isobutyl isonitrile (99mTc-MIBI) single photon emission computed tomography (SPECT) in differentiating malignant from benign lung lesions.The PubMed and Embase databases were comprehensively searched for relevant articles that evaluated lung lesions suspicious for malignancy. Two reviewers independently extracted the data on study characteristics and examination results, and assessed the quality of each selected study. The data extracted from the eligible studies were assessed by heterogeneity and threshold effect tests. Pooled sensitivity, specificity, diagnostic odds ratio (DOR), and areas under the summary receiver-operating characteristic curves (SROC) were also calculated.Fourteen studies were included in this meta-analysis. The pooled sensitivity, specificity, positive and negative likelihood ratio, and DOR of 99mTc-MIBI scan in detecting malignant lung lesions were 0.84 (95% confidence interval [CI]: 0.81, 0.87), 0.83 (95% CI: 0.77, 0.88), 4.22 (95% CI: 2.53, 7.04), 0.20 (95% CI: 0.12, 0.31), and 25.71 (95% CI: 10.67, 61.96), respectively. The area under the SROC was 0.9062. Meta-regression analysis showed that the accuracy estimates were significantly influenced by ethnic groups (P < 0.01), but not by image analysis methods, mean lesion size, or year of publication. Deek funnel plot asymmetry test for the overall analysis did not raise suspicion of publication bias (P = 0.50).Our results indicated that 99mTc-MIBI scan is a promising diagnostic modality in predicting the malignancy of lung lesions.

Potentials of computer simulation of lung tumors in comparison with ^99mТс-MIBI SPECT/CT data

“…Однофотонная эмиссионная компьютерная томография (ОФЭКТ) с Тс-МИБИ широко применяется для оценки перфузии миокарда левого желудочка, а в последнее десятилетие этот метод активно внедряется в клиническую практику диагностики опухолевых поражений легких. Анализ работ, посвященных применению метода ОФЭКТ/КТ с 99m Тс-МИБИ в оценке опухолевого поражения легких [2][3][4][5][6][7][8], показывает, что исследования сильно отличались по величине дозы вводимого препарата (335-1000 МБк) и параметрам записи сырых данных (60-120 ракурсов, время экспозиции 10-30 сек, интервал времени между введением трассера и сканированием 5-40 мин). Практически отсутствует информация о характеристиках используемых алгоритмов реконструкции (число подмножеств subsets, номер итерации останова), от которых может сильно зависеть полученное решение.…”

Uptake of 99mTc-MIBI by Sclerosing Pneumocytoma Raising a False Suspicion of Metastasis From Medullary Thyroid Carcinoma

“…The presence of a thyroid nodule with a sestamibi-hot and 99m Tc-cold phenotype is suspicious for malignancy and may warrant fine-needle aspiration before parathyroid adenoma resection. Interestingly, sestamibi imaging has also shown potential for predicting malignancy of pulmonary lesions with high (>80%) sensitivity and specificity, as confirmed by a recent meta-analysis [ 2 ]; therefore, some experts have suggested this imaging modality as a potential alternative to 18 F-fluorodeoxyglucose ( 18 F-FDG) positron emission tomography (PET)/CT, particularly in countries where access to the latter is limited because of higher costs. We present the case of a female patient diagnosed with medullary thyroid carcinoma (MTC) and primary hyperparathyroidism, in whom pulmonary metastasis was suspected in part because of increased sestamibi uptake by a pulmonary nodule, similar to the primary MTC lesion.…”