Role of 99mTc-Hexakis-2-Methoxy-Isobutylisonitrile in the Diagnosis and Staging of Lung Cancer

Nosotti, Mario; Santambrogio, Luigi; Gasparini, Massimo; Baisi, Alessandro; Bellaviti, Nadia; Rosso, Lorenzo

doi:10.1378/chest.122.4.1361

Cited by 29 publications

(17 citation statements)

References 15 publications

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“…In agreement with the literature [21,22], in all cases examined and subsequently subjected to histopathology, the use of SPECT with Tc-99m Sestamibi often provided support for radiological suspicion, but in selected highly suspicious cases, it prompted surgical excision rather than follow-up. The results suggest, consistent with the literature data [21,22], that Sestamibi has a high specificity in the identification of malignant lung lesions.…”

Section: Discussionesupporting

confidence: 81%

“…In virtù di questo il Tc-99m Sestamibi è stato utilizzato come radiofarmaco "oncotropo" per la studio di diverse neoplasie, incluso il tumore polmonare [20]. Nell'ambito del nostro studio l'applicazione della SPECT-TC con Tc-99m Sestamibi, sulla base di precedenti in letteratura [21,22] [23,20]. È stato poi osservato che nelle cellule neoplastiche, caratterizzate da chemioresistenza, si ha un rapido wash-out del Tc-99m Sestamibi, legato ad un'aumentata espressione di alcune P-glicoproteine di membrana [24,25].…”

Section: Discussioneunclassified

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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: Discussionesupporting

confidence: 81%

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

et al. 2006

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“…A number of studies evaluated MIBI in settings with a low prevalence of benign lesions [9,11]. MINAI et al [11] showed increased uptake in 19 out of 21 malignant lesions (sensitivity 85.7%), with all four benign lesions showing no uptake (specificity 100%).…”

Section: Discussionmentioning

confidence: 99%

“…MINAI et al [11] showed increased uptake in 19 out of 21 malignant lesions (sensitivity 85.7%), with all four benign lesions showing no uptake (specificity 100%). NOSOTTI et al [9] investigated 116 patients with potentially resectable lung lesions, of which 99 were malignant, and the sensitivity and specificity were 89% and 100%, respectively. Again, none of the benign lesions had a positive SPECT result.…”

Section: Discussionmentioning

confidence: 99%

“…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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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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Tc-99m Sestamibi in Miscellaneous Tumors

Sabet

2011

99mTc-Sestamibi

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Role of 99mTc-Hexakis-2-Methoxy-Isobutylisonitrile in the Diagnosis and Staging of Lung Cancer

Cited by 29 publications

References 15 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

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

Tc-99m Sestamibi in Miscellaneous Tumors

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Role of 99mTc-Hexakis-2-Methoxy-Isobutylisonitrile in the Diagnosis and Staging of Lung Cancer

Cited by 29 publications

References 15 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

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

Tc-99m Sestamibi in Miscellaneous Tumors

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Product

Resources

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