Thallium-201-chloride thyroid scintigraphy to evaluate benign and/or malignant nodules usefulness of the delayed scan

Summary Thallium-201 single-photon emission computerized tomography (SPECT) was used to clarify the relationship between 201TI uptake and the response in chemotherapy to platinum compounds in 21 patients with small-cell lung cancer. 201TI-SPECT scans were obtained twice: at 15 min (early scan) and 120 min (delayed scan) after an intravenous injection of 111 MBq (3 mCi) of thallium-201 chloride. We obtained the uptake ratio from each scan and calculated the retention index:uptake ratio = region of interest uptake / contralateral normal lung uptake; retention index = (delayed ratio -early ratio)/early ratio. After 201TI scintigraphy, 12 patients received chemotherapy consisting of platinum compounds and nine were treated with chemoradiation. Among patients receiving only chemotherapy, the retention index correlated with the responses to chemotherapy. In an in vitro study, ouabain, an inhibitor of the Na,K-ATPase pump, reduced sensitivity to cisplatin and inhibited intracellular thallium uptake in the small-cell lung cancer cell line. These studies suggest that 201TI-SPECT is a useful indicator of response to chemotherapy with platinum compounds in small-cell lung cancer, and that Na,K-ATPase is commonly involved in transporting both thallium and platinum compounds into cancer cells.Keywords: 201TI-SPECT; chemotherapy; inductively coupled plasma mass spectrometry; cisplatin; Na,K-ATPase Cisplatin (CDDP) is a useful anti-cancer agent, particularly when used in the treatment of human ovarian, testicular, bladder and small-cell lung cancer (Loehrer et al, 1984;Ohmori et al, 1993). Many studies on cisplatin resistance mechanisms have revealed that the decline in intracellular accumulation of cisplatin is important in carcinoma cell lines (Hromas et al, 1987;Kraker and Moore, 1988;Andrews and Howell, 1990;Mann et al, 1990). Cisplatin accumulation in these cells is reported to be regulated by an alteration in their Na,K-ATPase levels (Kawai et al, 1987;Andrews et al, 1991;Ohmori et al, 1993). Thus, the response to chemotherapy with cisplatin might depend on alterations of Na,K-ATPase.Thallium-201 (201TI) scintigraphy is now used to diagnose myocardial infarction (Strauss et al, 1975), myocardial ischaemia (Strauss and Boucher, 1986) and thyroid tumour (Bleichrodt et al, 1987;Charkes et al, 1990). Recently, 207T1 single-photon emission computerized tomography (SPECT) was reported as being used to detect lung lesion (Tonami et al, 1989), and it is reportedly superior to gallium scintigraphy in detecting lung cancer (Itoh et al, 1992;Matsuno et al, 1992). Some studies demonstrated that TI accumulation in 201T1 scintigraphy is closely related to the Na,K-ATPase levels in malignant tumours (Britten and Blank, 1968;Muranaka, 1981;Kishida, 1987;Sehweil et al, 1989). And we reported that the delayed ratio is related to low levels of Na,K-ATPase activity (Takekawa et al, 1996). We hypothesized that the degree of TI uptake to tumour in 201Tl scintigraphy is associated with the response to chemotherapy with platinum compounds th...

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“…(Ochi et al, 1982;Tonami et al, 1989;El-desouki 1991). show accumulation of 201TI on both the early and the delayed scans.…”

Section: |mentioning

confidence: 99%

Predicting chemotherapeutic response to small-cell lung cancer of platinum compounds by thallium-201 single-photon emission computerized tomography

Tokuchi

Isobe²,

Takekawa³

et al. 1998

Br J Cancer

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“…Thallium-201 (/°iT1) has been shown to accumulate similarly to gallium-67 citrate (Winchell 1976) in a variety of benign and malignant tumours (Hisada et al 1978;Ochi et al 1982). The mechanism of the initial extraction of 2°lT1 by the neoplastic tissue seems not to be a completely flow-dependent process.…”

Section: Discussionmentioning

confidence: 99%

Abnormal uptake of technetium-99m hexakis-2-methoxyisobutylisonitrile in a primary cardiac lymphoma

Medolago¹,

Virotta

Pitì

et al. 1992

Eur J Nucl Med

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Abnormally high uptake of technetium-99m hexakis-2-methoxyisobutylisonitrile (99mTc-SESTAMIBI) in the right ventricle and in the septum was observed in a 47-year-old woman initially presenting with dysarthria and left hemiparesis. Endomyocardial biopsy demonstrated a high-grade malignant non-Hodgkin's lymphoma. Complete remission was achieved by combined cyclophosphamide, doxorubicin, vincristine and prednisone (CHOP) chemotherapy and radiotherapy of the heart and mediastinum. The post-remission single photon emission tomography (SPET) 99mTc-SESTAMIBI study showed a homogeneous distribution pattern, in agreement with echocardiography computed tomography and magnetic resonance imaging. Increased uptake of 99mTc-SESTAMIBI, a myocardial perfusion agent, has been observed in some benign and malignant tumours. It may prove to be useful in the diagnosis and follow-up of malignancies.

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“…Though this isotope is reported to be highly sensitive in the diagnosis of differentiated carcinoma, 29 it has a low ability to distinguish between malignant and benign lesions. Ochi et al 30 introduced the technique of early and delayed scanning in order to enhance the diagnostic accuracy of thallium 201 scanning. They reported that this technique has increased the specificity of the method to 90% without a decrease in sensitivity (95%).…”

Section: Other Uses For the 99m Tc Scanmentioning

confidence: 99%

Is the Technetium 99M Scan Useful in Screening for Nontoxic Solitary Thyroid Nodules?

Al-Tameem

1990

Ann Saudi Med

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The proposed benefits of the technetium ( 99m Tc) scan in the screening of patients with clinically solitary thyroid nodules were assessed. One hundred seventy-eight patients with such lesions underwent Tc scanning followed by surgical resection. The solitary nature of the lesion was confirmed by Tc scanning in 153 (86%) patients. In the remaining 25 (14%), the scan showed patchy uptake by the thyroid gland, suggesting subclinical multinodularity. Of these 25 patients with conflicting clinical and scan findings, the lesion was confirmed to be solitary by operative and pathological findings in ten (40%) patients, of whom two patients had thyroid malignancies that might have been misdiagnosed as multinodular goiter. In the other 15 (60%) patients, the scan was accurate in detecting subclinical multinodularity, but again, two patients in this group had thyroid malignancies that might have been misdiagnosed as multinodular goiter. These findings indicate that the 99m

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Thallium-201-chloride thyroid scintigraphy to evaluate benign and/or malignant nodules usefulness of the delayed scan

Cited by 80 publications

References 4 publications

Predicting chemotherapeutic response to small-cell lung cancer of platinum compounds by thallium-201 single-photon emission computerized tomography

Predicting chemotherapeutic response to small-cell lung cancer of platinum compounds by thallium-201 single-photon emission computerized tomography

Abnormal uptake of technetium-99m hexakis-2-methoxyisobutylisonitrile in a primary cardiac lymphoma

Is the Technetium 99M Scan Useful in Screening for Nontoxic Solitary Thyroid Nodules?

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