THE ROLE OF Tc-99m MIBI SPECT IN THE EVALUATION OF NON-SMALL CELL LUNG TUMORS

Abstract

Objective: In this study, it was aimed to investigate the role of Tc-99m MIBI scintigraphy in the diagnosis and evaluation of non-small cell lung cancers and also to evaluate the use of MIBI scintigraphy and MDP bone scintigraphy together in the detection of metastases. Methods: For this purpose, 30 patients with non-small cell lung cancer and 15 patients with benign lesions other than lung cancer (as a control group) were included in the study. By applying Tc-99m MIBI and Tc99m MDP scintigraphy to whole patients with benign and malign lung lesions, anterior-posterior planar and SPECT MIBI images were obtained. Bone scintigraphy was performed as whole-body images. Scintigraphic findings were compared with the histopathological diagnosis of patients. Data were analyzed statistically. Results: According to the result of the findings, the sensitivity, specificity, positive, predictive value, negative predictive value, and accuracy rate of Tc-99m MIBI scintigraphy in the detection of non-small cell lung tumors were determined as 87%, 93.5%, 96%, 77.7%, and 88.8%, respectively. Scintigraphic findings were evaluated quantitatively and visually. While there was no statistically significant difference between the early uptake rates of non-small cell lung tumors and benign lesions in the quantitative evaluation using planar MIBI images, late Tc-99m MIBI uptake rates were significantly higher in lesions with non-small cell lung tumors than that of benign lesions. However, it was detected that both the early and late uptake ratios were significantly higher in malign lesions than in benign lesions in the quantitative evaluation of SPECT images. It was observed that MIBI washout in benign lesions was higher than in malignant lesions in visual washout analysis. Additionally, multiple bone metastases were observed in 14 patients on the visual evaluation of bone scan of the patients with non-small cell lung cancer. Tc-99m MDP uptake was not observed in the malignant lung lesion region or in the soft tissue except the lesion. Conclusion: In light of the findings, it was concluded that Tc-99m MIBI scintigraphy is a noninvasive method with high sensitivity and specificity that can be used to differentiate non-small cell lung tumors from benign lesions.