Evaluation of histopathological differentiation in lung adenocarcinoma patients using 201Tl-chloride and 99Tcm-MIBI SPET

Abstract

The purpose of this prospective study was to evaluate the relationship between thallium-201 chloride (201Tl) and technetium-99m hexakis 2-methoxyisobutylisonitrile (99Tcm-MIBI) accumulation and histopathological differentiation in primary lung adenocarcinoma. A total of 43 patients with primary lung adenocarcinoma were investigated. The patients were divided into well differentiated (n = 17), moderately differentiated (n = 14) and poorly differentiated (n = 12) carcinoma groups. Simultaneous dual single photon emission tomography (SPET) images with 201Tl and 99Tcm-MIBI were acquired 15 min (early) and 2 h (delayed) after injection. Using a region of interest technique, the tumour-to-normal lung ratio was calculated for both early (early ratio) and delayed (delayed ratio) images. The retention index was calculated using the formula delayed ratio/early ratio. Uptake of the radionuclides was compared with the classification of tumour differentiation grading. The mean (+/- SD) values of the early ratio, delayed ratio and retention index using 201Tl were 2.19+/-0.72, 2.28+/-0.71 and 1.06+/-0.16, respectively, in the well differentiated group, 2.38+/-0.83, 2.48+/-0.84 and 1.08+/-0.23, respectively, in the moderately differentiated group, and 2.87+/-0.75, 3.60+/-1.51 and 1.22+/-0.21, respectively, in the poorly differentiated group. Both the ratios and the retention index using 201Tl were significantly lower in the well differentiated group than in the poorly differentiated group. The delayed ratio using 201Tl in the moderately differentiated group was also significantly lower than that in the poorly differentiated group. There were no significant differences in either ratio or the retention index among the three groups using 99Tcm-MIBI. 201Tl SPET is superior to 99Tcm-MIBI SPET for the grading of histopathological differentiation of primary lung adenocarcinoma.

Incidental Detection of Malignant Pleural Effusion on Sestamibi Myocardial Perfusion Scan

“…Therefore, our finding (radiotracer activity corresponding to the region of pleural effusion) could be explained by radiotracer uptake by the malignant cells of the effusion, a phenomenon which is widely described previously [7][8][9].…”

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

“…Commonly used tracers in lung cancer imaging by SPECT include 99m Tc-depreotide, talium-201 chloride ( 201 Tl), and technetium-99m methoxy isobutyl isonitrile ( 99m Tc-MIBI). 9 – 11 Encouraging results in lung cancer detection have been obtained with 99m Tc-MIBI, a lipophilic cation widely used as a tracer for myocardial perfusion imaging. 12 , 13 99m Tc-MIBI has been emphasized in clinical use due to its shorter half-life, improved spatial resolution, lower cost, and easy availability.…”

Lung tumors: Early and delayed ratio of 99mTc-methoxy-2-isobutylisonitrile accumulation

“…Commonly used radiopharmaceuticals in lung cancer imaging are 201 Tl-chloride (talium-201 chloride) and 99m Tc-MIBI (technetium-99m labelled hexakis-2-methoxyisobutylisonitrile) [1][2][3] . New studies introduce simultaneous double-tracer single photon emission tomography (SPECT) with 99m-Tctechnetril and 67-Ga-citrate for follow-up of patients with nonsmall cell lung cancer 4 .…”