Differentiation of single solid lesions in the lungs by means of single-photon emission tomography with technetium-99m methoxyisobutylisonitrile

Kao, Chia‐Hung; Wang, Shyh-Jen; Lin, Wan‐Yu; Hsu, Chia‐Chi; Liao, Shu-Quinn; Yeh, Su‐Ling

doi:10.1007/bf00170007

Cited by 44 publications

(27 citation statements)

References 10 publications

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“…Encouraging results in lung cancer diagnosis have been obtained with single photon emission computed tomography (SPECT) using 99mTc-hexakis-2-methoxy-isobutyl-isonitrile (Sestamibi), a lipophilic cation used in myocardial perfusion scintigraphy [2][3][4].…”

Section: Introductionmentioning

confidence: 99%

Integrated multislice CT and Tc–99m Sestamibi SPECT–CT evaluation of solitary pulmonary nodules

et al. 2006

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Purpose. The purpose of this study was to evaluate efficacy of multislice computed tomography (MSCT) and single photon emission computed tomography (SPECT)-CT with Tc-99m Sestamibi in the assessment of solitary pulmonary nodules of uncertain significance. Scintigraphy was performed using a 'hybrid' g-camera that allows simultaneous acquisition of SPECT and CT images, with interesting results in diagnostic oncology. Materials and methods. Between September 2003 and August2004, 23 patients with a solitary pulmonary nodule detected on CT underwent SPECT-CT using Tc-99m Sestamibi as a radiotracer. Nodules with positive scintigraphy were immediately subjected to biopsy or surgical resection. Nodules with negative scintigraphy were followed up after 3-4 months by MSCT with automatic segmentation software (Advanced Lung Analysis, ALA) and histological characterisation. Results. Of the 23 nodules (size range 0.8-2 cm) discovered with MSCT, 11 showed intense uptake of Tc-99m Sestamibi. Ten lesions were true positive: seven adenocarcinomas, one squamous cell carcinoma, one large cell carcinoma and one metastasis. The only false positive was histologically classified as a large cell granuloma. Twelve lesions had negative scintigraphy: five fibrous lesions, three hamartomas, three granulomas and one adenocarcinoma (false negative). Benign nodules without tracer uptake underwent another CT scan 3-4 months later, which confirmed stability of the nodule size. Correlation of Sestamibi SPECT with histology showed sensitivity (Se) of 90.9 %, specificity (Sp) of 91.6 %, diagnostic accuracy of 91.3 %, positive predictive value (PPV) of 90.9% and negative predictive value (NPV) of 91.6 %. Conclusions. The integrated use of MSCT and Tc-99m Sestamibi SPECT-CT could be very useful in the management of solitary pulmonary nodules (SPNs). In particular, in our preliminary study, scintigraphy provided significant diagnostic information to differentiate benign from suspicious pulmonary nodules. The use of scintigraphy could be helpful to anticipate histological assessment and surgical treatment of SPNs identified at CT. Radiol med (2006) 111:213-224 DOI 10.1007 Integrated multislice CT and Tc-99m Sestamibi SPECT-CT evaluation of solitary pulmonary nodules TC multistrato e SPECT-TC con Tc-99m Sestamibi: diagnostica integrata nella caratterizzazione del nodulo polmonare solitario Key words

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Section: Introductionmentioning

confidence: 99%

Integrated multislice CT and Tc–99m Sestamibi SPECT–CT evaluation of solitary pulmonary nodules

et al. 2006

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“…There have been an increasing number of studies describing 99m Tc-MIBI accumulation in tumors, including tumors of the parathyroid gland (5), brain (6), lung (7,8), breast (9), and thyroid gland (10). To know whether 99m Tc-MIBI can also accumulate in gastric cancer tissues, we quantitatively evaluated the ER and DR from the early (30 min) and delayed (120 min) images after i.v.…”

Section: Resultsmentioning

confidence: 99%

“…99m Tc-Sestamibi ( 99m Tc-MIBI), a lipophilic cation originally developed for scintigraphic evaluation of coronary blood flow (3,4), has been used for imaging of tumors originating from multiple organs, such as the parathyroid gland (5), brain (6), lung (7,8), breast (9), and thyroid gland (10). Because 99m Tc-MIBI is passively taken up into the mitochondria in metabolically active tumor cells and exported from cells by P-gp (11,12), this imaging procedure has been also applied to detect functional P-gp expression and to predict sensitivity of cancer cells to chemotherapy in some types of cancers (13)(14)(15)(16)(17)(18)(19).…”

Section: Introductionmentioning

confidence: 99%

Usefulness of 99mTc-Sestamibi Scintigraphy in Suggesting the Therapeutic Effect of Chemotherapy against Gastric Cancer

Kawata

Kanai

Sasada

et al. 2004

Clinical Cancer Research

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Purpose: Imaging with 99m Tc-sestamibi ( 99m Tc-MIBI) has been used to assess 170-kDa P-glycoprotein (P-gp) expression and predict chemotherapy responses in several types of malignancy, such as breast and lung cancers. The purpose of this study was to evaluate the relationship between 99m Tc-MIBI accumulation in tumors and sensitivity to chemotherapy in gastric cancer patients.Experimental Design: Thirty-six patients with advanced gastric cancer underwent 99m Tc-MIBI scintigraphy before chemotherapy. Patients also underwent endoscopic biopsy, and the expression of P-gp or multidrug resistance-associated protein was analyzed by immunohistochemical staining. The relationship between the accumulation of 99m Tc-MIBI in tumors and responses to chemotherapy with 5-fluorouracil/cis-diamminedichloroplatinum(II) or epirubicin was examined.Results: Higher accumulation of 9m Tc-MIBI in tumors was observed in 25 and 23 of 36 gastric cancer patients at the early (30 min) and delayed (120 min) images, respectively. Accelerated accumulation of 99m Tc-MIBI negatively correlates with increased expression of P-gp, but not of multidrug resistance-associated protein, as determined by immunohistochemistry in gastric cancer tissues. The response rate to 5-fluorouracil/cis-diamminedichloroplatinum(II) chemotherapy in patients with high 99m Tc-MIBI accumulation (15.4%) was much lower than that in patients with low 99m Tc-MIBI accumulation (54.5%). In contrast, patients with high 99m Tc-MIBI accumulation show a higher response rate (41.7%) to chemotherapy with epirubicin, which is known to be a substrate of P-gp transporter. Conclusions:99m Tc-MIBI scintigraphy is useful to suggest the responses to chemotherapy of patients with advanced gastric cancer.

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“…Radiopharmaceuticals containing either technetium-99m ( 99m Tc) or thallium-201 ( 201 Tl) are more affordable than FDG since they can be produced on site and do not need a cyclotron facility. These markers accumulate in lung carcinoma and, therefore, pulmonary lesions can be evaluated with widely available gamma cameras [7][8][9][10][11]. Methoxy isobutyl isonitrile (MIBI) is taken up primarily by mitochondria and studies have shown favourable characteristics in the evaluation of SPN, albeit only in settings with low incidence of benign lesions [10][11][12].…”

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confidence: 99%

Solitary pulmonary nodule evaluation with^99mTc-methoxy isobutyl isonitrile in a tuberculosis-endemic area

Schuurmans¹,

Ellmann²,

Bouma³

et al. 2007

Eur Respir J

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High prevalence of tuberculosis increases the odds for nonmalignant solitary pulmonary nodules (SPNs). Positron emission tomography (PET) using 18 F-fluorodeoxyglucose is the method of choice for the identification of malignant SPNs requiring curative surgery. However, PET is not widely available. Technetium-99m methoxy isobutyl isonitrile (MIBI) is inexpensive, widely available and shows increased uptake in malignant SPNs. The aim of the present study was to prospectively evaluate the diagnostic value of MIBI single photon emission computed tomography to distinguish between benign and malignant SPNs in a tuberculosis-endemic area.In total, 49 patients with radiologically indeterminate SPNs (single lesion f6 cm in diameter) were prospectively evaluated with MIBI. The final diagnosis was established with bronchoscopy, fine-needle aspiration, surgical resection or clinical follow-up for o2 yrs.A total of 12 (92%) out of 13 malignant lesions showed increased uptake of MIBI, while no uptake was observed in 33 (92%) out of 36 benign lesions. MIBI uptake indicated malignancy with a sensitivity and specificity of 92% and a negative predictive value of 97%.In this tuberculosis-endemic area, technetium-99m methoxy isobutyl isonitrile single photon emission computed tomography evaluation of solitary pulmonary nodules had a high negative predictive value. Therefore, it has the potential to prevent unnecessary surgical resections of benign nodules and serve as a low-cost alternative when positron emission tomography is not available.

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Differentiation of single solid lesions in the lungs by means of single-photon emission tomography with technetium-99m methoxyisobutylisonitrile

Cited by 44 publications

References 10 publications

Integrated multislice CT and Tc–99m Sestamibi SPECT–CT evaluation of solitary pulmonary nodules

Integrated multislice CT and Tc–99m Sestamibi SPECT–CT evaluation of solitary pulmonary nodules

Usefulness of 99mTc-Sestamibi Scintigraphy in Suggesting the Therapeutic Effect of Chemotherapy against Gastric Cancer

Solitary pulmonary nodule evaluation with^99mTc-methoxy isobutyl isonitrile in a tuberculosis-endemic area

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Differentiation of single solid lesions in the lungs by means of single-photon emission tomography with technetium-99m methoxyisobutylisonitrile

Cited by 44 publications

References 10 publications

Integrated multislice CT and Tc–99m Sestamibi SPECT–CT evaluation of solitary pulmonary nodules

Integrated multislice CT and Tc–99m Sestamibi SPECT–CT evaluation of solitary pulmonary nodules

Usefulness of 99mTc-Sestamibi Scintigraphy in Suggesting the Therapeutic Effect of Chemotherapy against Gastric Cancer

Solitary pulmonary nodule evaluation with99mTc-methoxy isobutyl isonitrile in a tuberculosis-endemic area

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Solitary pulmonary nodule evaluation with^99mTc-methoxy isobutyl isonitrile in a tuberculosis-endemic area