Evaluation of Tl-201 SPECT for monitoring the treatment of pulmonary and mediastinal tumors

Namba, Ryuichiro; Narabayashi, Isamu; Matsui, Ritsuo; Sueyoshi, Kozo; Nakata, Y; Tabuchi, K; Komori, Tsuyoshi

doi:10.1007/bf03164969

Cited by 4 publications

(2 citation statements)

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“…Nevertheless, this method is insufficient for assessing the therapeutic effects soon after starting therapy, since treated tumors may show signs of slow regression even in successful therapy. [1][2][3][4][5][6][7] Received August 3, 1998, revision accepted October 2, 1998. Thallium-201-chloride (201 T1) has recently been proven useful for assessing the therapeutic response of a variety of malignant tumors, [7][8][9][10][11][12][13][14][15] and our previous animal study using VX-2 tumors indicated that tumor 201 T1 uptake was altered soon after irradiation.…”

Section: Introductionmentioning

confidence: 99%

“…[1][2][3][4][5][6][7] Received August 3, 1998, revision accepted October 2, 1998. Thallium-201-chloride (201 T1) has recently been proven useful for assessing the therapeutic response of a variety of malignant tumors, [7][8][9][10][11][12][13][14][15] and our previous animal study using VX-2 tumors indicated that tumor 201 T1 uptake was altered soon after irradiation. 16 If we could assess tumor response soon after starting therapy, it would be beneficial when considering additional therapeutic regimens in some patients, and ultimately the patient's prognosis would improve.…”

Section: Introductionmentioning

confidence: 99%

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201Tl SPECT as an indicator for early prediction of therapeutic effects in patients with non-small cell lung cancer

et al. 1998

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This study retrospectively investigated the good parameters on thallium-201 chloride (201Tl) SPECT for early assessment of the therapeutic effects in patients with non-small cell lung cancer. Based on tumor response as determined by chest CT scan about 9 weeks after the end of irradiation with adjuvant chemotherapy, the subjects were divided to the responder group (tumor regression > 50%, n = 13) and non-responder group (tumor regression < 50%, n = 13). 201Tl SPECT was performed before and at the halfway through the course of therapy (average tumor dose, 27.4 Gy +/- 4.5) in all the patients. SPECT was conducted twice 15 min (early scan) and 120 min (delayed scan) after intravenous injection of 148 MBq (4 mCi) of 201Tl. Tumor-to-contralateral normal lung tissue count ratios on both scans were calculated as early and delayed uptake ratios (EUR and DUR), and a retention index (RI) was also derived from these ratios. In the responder group, a significant decrease in DUR and RI halfway through the therapy was observed compared to pretreatment (2.6 +/- 0.6 vs. 3.5 +/- 1.0; p < 0.01, and -2.3% +/- 25.5 vs. 37.4% +/- 17.8; p < 0.001, respectively), even though EUR did not change significantly (N.S.). By contrast, in the non-responder group, there were no significant changes in any of these parameters (N.S.). When comparing DUR and RI for the two groups halfway through the therapy, DUR and RI were significantly lower in the responder group (both; p < 0.01), but no significant difference was noted in EUR (N.S.), and the percent reduction in tumor size did not correlate with the percent decrease in DUR or RI (N.S.). These results indicate that the extent of decrease in DUR and RI after therapy can be a useful parameter for early assessment of the therapeutic effects in patients with non-small cell lung cancer.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

201Tl SPECT as an indicator for early prediction of therapeutic effects in patients with non-small cell lung cancer

et al. 1998

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Monitoring the chemotherapeutic response in primary lung cancer using 99mTc-MIBI SPET

et al. 2001

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Prediction and evaluation of the response to chemotherapy (CTx) are important for the correct and cost-effective treatment of patients with primary lung cancer. Although fluorine-18 fluorodeoxyglucose positron emission tomography (FDG-PET) is accepted as the most useful and accurate nuclear medicine technique for this purpose, its expense and limited availability restrict its use. Compared with PET agents, technetium-99m methoxyisobutylisonitrile (MIBI), which is used in nuclear oncology, is cheaper and available in any nuclear medicine clinic. With this in mind, in this study we aimed to evaluate the role of 99mTc-MIBI in monitoring the chemotherapeutic response in primary lung cancer. Twenty patients with primary lung cancer underwent 99mTc-MIBI single-photon emission tomography (SPET) at 15 min (early) and 3-4 h (delayed) after injection of the tracer. All patients underwent 99mTc-MIBI SPET study twice: before and after the 3rd cycle of CTx. Patients were divided into two groups, responders [R(+), n=10] and nonresponders [R(-), n=10], according to the change in tumour size on CT scan taken 2 weeks after the last cycle of the CTx. From the SPET images early and delayed tumour/lung ratios (ER and DR) were obtained before and after CTx. In the R(+) group, ER and DR decreased significantly after CTx, from 3.28+/-1.55 to 1.78+/-0.72 (P<0.04) and from 3.23+/-1.55 to 2.0+/-0.88 (P<0.05), respectively. However, in the R(-) group, while ER showed a slight and statistically insignificant increase after CTx (from 2.51+/-1.23 to 2.65+/-1.86), DR increased significantly, from 2.74+/-1.37 to 3.27+/-2.31 (P<0.03). The percentage decreases in ER and DR in the R(+) group after CTx was significantly higher than that in the R(-) group: 34.36%+/-26.7% vs -13.78%+/-27.58% (P<0.0002) and 29.45%+/-25.23% vs -18.58%+/-20.51% (P<0.0005), respectively. Using a decrease of > or =10% as a threshold for monitoring the chemotherapeutic response, 99mTc-MIBI had a sensitivity of 90% and a specificity of 100%. We found a positive correlation in 14 patients between ER and DR and survival: r=0.6754 and P=0.008, and r=0.5755 and P=0.031, respectively. Our results suggest that 99mTc-MIBI might be used in routine practice to monitor the chemotherapeutic response in patients with primary lung cancer, especially when PET is not available.

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Differentiation of Small Solitary Pulmonary Nodules Using Tc-99m MIBI and Tl-201 SPECT

Yamamoto

Nishiyama²,

Fukuda³

et al. 1999

Clinical Nuclear Medicine

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Evaluation of Tl-201 SPECT for monitoring the treatment of pulmonary and mediastinal tumors

Cited by 4 publications

References 10 publications

201Tl SPECT as an indicator for early prediction of therapeutic effects in patients with non-small cell lung cancer

201Tl SPECT as an indicator for early prediction of therapeutic effects in patients with non-small cell lung cancer

Monitoring the chemotherapeutic response in primary lung cancer using 99mTc-MIBI SPET

Differentiation of Small Solitary Pulmonary Nodules Using Tc-99m MIBI and Tl-201 SPECT

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