technetium-tc-99m-tetrofosmin and Carcinoma--Squamous-Cell

The aim of this study was to assess the usefulness of 99Tcm-tetrofosmin for detecting tumours of the lungs and adjacent structures and to compare the results with those for 201Tl. In the 18 patients studied, there were 30 lesions in total. Dual-isotope SPET acquisitions were performed 10 min and 3 h after the administration of 99Tcm-tetrofosmin and 201Tl. Image quality and semi-quantitative parameters were evaluated for both tracers. All lesions were detected by the two radiopharmaceuticals on both the early and delayed images. In seven patients, the image quality of 99Tcm-tetrofosmin was better than that of 201Tl. For the detection of metastatic lymph nodes, the delayed 201Tl and the early 99Tcm-tetrofosmin images were superior. No significant difference was observed between the uptake ratios of the two tracers. 99Tcm-tetrofosmin showed significantly (P < 0.001) higher washout than 201Tl from both the lesions and normal lungs, although washout of 201Tl from normal lungs was significantly higher than that from the lesions. In conclusion, 99Tcm-tetrofosmin may be helpful for detecting tumours of the lungs and adjacent structures, but has limited applicability in differentiating between malignant and benign tumours and may not be used instead of 201Tl to detect malignant tumours of the lungs.

Topics: Adenocarcinoma; Adult; Aged; Aged, 80 and over; Carcinoma, Squamous Cell; Female; Humans; Image Processing, Computer-Assisted; Lung Neoplasms; Male; Middle Aged; Organophosphorus Compounds; Organotechnetium Compounds; Radiopharmaceuticals; Thallium Radioisotopes; Thoracic Neoplasms; Tomography, Emission-Computed, Single-Photon

Technetium-99m-tetrofosmin is a new myocardial imaging agent which has yielded promising results compared to thallium-201. The tumour-seeking properties of the routinely used cardiac radiopharmaceuticals 201TI and 99mTc-methoxyisobutylisonitrile are well known. Here we report the results of a pilot study demonstrating 99mTc-tetrofosmin uptake in malignant lung tumours. Five patients with bronchial carcinoma, each in different stages of chemo- or radiotherapy, were imaged. Dynamic and static acquisitions were performed to evaluate the uptake and kinetics of 99mTc-tetrofosmin in the lesions. In four of the five patients localized tumour uptake of 99mTc-tetrofosmin was observed. Time to peak tumour activity and tracer washout in the tumour, myocardium and contralateral normal lung at 30 min post injection (p.i.) were determined. Tumour/normal lung, heart/tumour and heart/contralateral normal lung ratios were calculated for 5-10, 25-30 and 85-90 min p.i. The peak concentration in all tumours was reached at the end of the first minute. The mean tumour and contralateral normal lung washout rates of 99mTc-tetrofosmin at 30 min p.i. were 18.3% +/- 9.2% and 19.5% +/- 5.85% respectively. The tumour/contralateral normal lung ratio remained higher than 1.25 until 90 min p.i. in all four patients. It is concluded that 99mTc-tetrofosmin seems to be of value in lung tumour imaging, although larger studies are necessary to ascertain its sensitivity, specificity and usefulness in clinical practice.

Topics: Adenocarcinoma; Adult; Aged; Carcinoma, Squamous Cell; Female; Humans; Lung Neoplasms; Male; Middle Aged; Organophosphorus Compounds; Organotechnetium Compounds; Pilot Projects; Radionuclide Imaging

In order to investigate the clinical significance of (99m)Tc-Tetrofosmin (TF) scintigraphy in the evaluation of lung cancer and mediastinal lymphoid node involvement, 33 patients with pulmonary neoplasmas were subjected to both (99m)Tc-TF scintigraphies and CT scans in one week before their operations or puncturations. All the images were judged visually and the emission images were analyzed with semi-quantitative methods in addition. The results of each group were compared. There was marked difference in target/non-target (T/N) ratio between the lung cancer group and the benign lesion group (P<0.001). Moreover, in the lung cancer group, T/N ratio in tomographies was significantly higher than that in planar images (P<0.01). The sensitivity and accuracy of semi-quantitative analysis in (99m)Tc-TF SPECT were significantly higher than those of CT in the diagnosis of pulmonary neoplasmas (P<0.05 and P<0.01 respectively), so was the sensitivity of (99m)Tc-TF SPECT vs CT in the diagnosis of mediastinal lymphoid node metastasis (P<0.05). It was also found that epidermoid squamous cell carcinomas and adenocarcinomas had a higher T/N ratio than in small cell carcinomas (P<0.05), and 2 h washout rate (WR) of adenocarcinomas was higher than that of epidermoid squamous cell carcinomas (P<0.05). In conclusion, (99m)Tc-TF scintigraphy showed a favorable diagnostic accuracy in appraising lung cancers and mediastinal lymph node metastases. Furthermore semi-quantitative technology can improve the accuracy, and is potential to offer some information about histological type of the cancer tissue. Therefore, (99m)Tc-TF scintigraphy will be a useful tool in the diagnosis and staging of lung cancer.

Topics: Adenocarcinoma; Carcinoma, Squamous Cell; Female; Humans; Lung Neoplasms; Lymphatic Metastasis; Male; Mediastinum; Organophosphorus Compounds; Organotechnetium Compounds; Radiopharmaceuticals; Tomography, Emission-Computed, Single-Photon

Topics: Biopsy, Needle; Carcinoma, Bronchogenic; Carcinoma, Squamous Cell; False Negative Reactions; Humans; Lung Neoplasms; Male; Middle Aged; Organophosphorus Compounds; Organotechnetium Compounds; Radiography; Radiopharmaceuticals; Somatostatin; Thallium; Tomography, Emission-Computed, Single-Photon

Tc-99m-tetrofosmin is an agent to delineate cancer. To elucidate the usefulness of Tc-99m-tetrofosmin scintigraphy, we analyzed the relationship between the uptake of Tc-99m-tetrofosmin and histopathology in patients with lung cancer. SPECT studies were conducted twice: 15 minutes (early scan), and 60 minutes (delayed scan), after intravenous injection of 740 MBq Tc-99m-tetrofosmin. We calculated the retention index in order to evaluate the degree of Tc-99m-tetrofosmin retention in the primary tumor. The retention indices were significantly lower in squamous cell carcinoma than those of small cell carcinoma or adenocarcinoma. As the retention indices of Tc-99m-tetrofosmin were different in each histopathology, the index might play a part as a tumor marker of lung cancer.

Topics: Adenocarcinoma; Adolescent; Adult; Aged; Carcinoma, Small Cell; Carcinoma, Squamous Cell; Child; Child, Preschool; Female; Humans; Infant; Lung; Lung Neoplasms; Male; Middle Aged; Organophosphorus Compounds; Organotechnetium Compounds; Radiopharmaceuticals; Tomography, Emission-Computed, Single-Photon

We used thoracic SPECT to study the 99mTc-tetrofosmin (TF) uptake in patients with non-small-cell-lung-carcinoma (NSCLC). The results were compared with the percentage of P-glycoprotein (Pgp) found in flow cytometric analysis (FC) of samples of surgically-resected tumor tissue.. A total of 21 patients with NSCLC were studied by means 99mTC-TF and thoracic SPECT. Image analysis included the determination of the TF uptake rate in the lung mass with respect to that of healthy tissue of the contralateral lung. These rates were compared with the percentage of Pgp expression according to FC. FC analysis was also carried out in 16 samples of healthy lung tissue obtained from the patients.. In healthy lung tissue, the mean Pgp expression according to FC was 4.58 +/- 1.87%. The cutoff value used to differentiate between Pgp positive and Pgp negative tumors was considered to be the mean plus two standard deviations (8.32). The Pgp-positive tumors (> 8.32%) presented significantly lower uptake levels (1.28 +/- 0.39) than the Pgp-negative lesions (1.66 +/- 0.33) (p = 0.029).. There is a inverse correlation between the Pgp expression as determined by FC analysis and 99mTc-TF in NSCLC. Thus, this radiopharmaceutical provides rapid and non-invasive information on Pgp expression in these lesions.

Topics: Adenocarcinoma; Adult; Aged; ATP Binding Cassette Transporter, Subfamily B, Member 1; Carcinoma, Adenosquamous; Carcinoma, Non-Small-Cell Lung; Carcinoma, Squamous Cell; Drug Resistance, Multiple; Drug Resistance, Neoplasm; Female; Flow Cytometry; Humans; Lung; Lung Neoplasms; Male; Middle Aged; Neoplasm Proteins; Organophosphorus Compounds; Organotechnetium Compounds; Radiopharmaceuticals; Tomography, Emission-Computed, Single-Photon

The intention of this prospective study was to compare the diagnostic potential of technetium-99m sestamibi (MIBI) and a novel radiotracer, 99mTc-Tetrofosmin (Tetro), for the assessment of primary nasopharyngeal carcinoma (NPC) and the differentiation of residual disease from post-therapy changes. A total of 38 patients underwent MIBI and Tetro single-photon emission tomography (SPET) imaging at initial presentation (n=22) or following therapy (n=16). The findings were correlated with computed tomography or magnetic resonance imaging (MRI) on a site-by-site basis. Tumour/background (Tm/Bkg) ratios were obtained on coronal sections. Biopsy (nine patients) and/or 12- to 24-month clinical follow-up data were available in the post-therapy group. All primary disease sites were accurately detected by both imaging studies. Although there was no statistical difference between the two imaging techniques in the detection of primary disease, MIBI was superior to Tetro in the detection of regional lymph node metastases (sensitivity: 95% vs 79%). Tetro and MIBI SPET were true-positive in all patients (n=7) with proven residual/recurrent disease. In nine patients who had no evidence of residual/recurrent tumour, MRI was false-positive in five while Tetro and MIBI SPET were false-positive in two and three patients, respectively. Tm/Bkg ratios were

Topics: Carcinoma; Carcinoma, Squamous Cell; Female; Humans; Lymphatic Metastasis; Male; Middle Aged; Nasopharyngeal Neoplasms; Neoplasm Recurrence, Local; Neoplasm, Residual; Organophosphorus Compounds; Organotechnetium Compounds; Prospective Studies; Radiopharmaceuticals; Sensitivity and Specificity; Technetium Tc 99m Sestamibi; Tomography, Emission-Computed, Single-Photon

We evaluated the usefulness of 99Tcm-tetrofosmin imaging in lung cancer. The study sample comprised 46 patients with lung cancer. Single photon emission tomography was conducted after the intravenous injection of 740 MBq 99Tcm-tetrofosmin and 111 MBq 201T1-chloride. We obtained an uptake ratio (counts per pixel in the lesion/counts per pixel in contralateral normal lung) for each scan to evaluate the degree of uptake in the tumour. Our results demonstrate that 89.1% of the primary lung cancers were visualized by 99Tcm-tetrofosmin and 95.7% by 201T1. The difference between the 201T1 uptake ratio and the 99Tcm-tetrofosmin uptake ratio was significantly greater in squamous cell carcinomas than small cell carcinomas (P < 0.01) and tended to be greater in squamous cell carcinomas than adenocarcinomas (P = 0.093). This study has indicated that 99Tcm-tetrofosmin, like 201T1, is a highly effective agent in the delineation of lung cancer. The difference between the 99Tcm-tetrofosmin and 201T1 uptake ratios might provide further information regarding the histological type of lung cancer.

Topics: Adenocarcinoma; Aged; Aged, 80 and over; Carcinoma, Small Cell; Carcinoma, Squamous Cell; Female; Humans; Lung Neoplasms; Male; Organophosphorus Compounds; Organotechnetium Compounds; Radiopharmaceuticals; Sensitivity and Specificity; Thallium Radioisotopes; Tomography, Emission-Computed, Single-Photon

Topics: Aged; Barium Sulfate; Carcinoma, Squamous Cell; Contrast Media; Esophageal Neoplasms; Humans; Magnetic Resonance Imaging; Male; Organophosphorus Compounds; Organotechnetium Compounds; Radiopharmaceuticals; Tomography, Emission-Computed, Single-Photon

Technetium-99m-tetrofosmin has emerged as a new radiopharmaceutical for myocardial imaging, in competition with 201Tl and 99mTc-MIBI. In this study, 99mTc-tetrofosmin was evaluated for its ability to detect malignant and benign lesions from single solid lung masses.. Forty-nine patients with a single solid lung mass based on chest radiograph findings received 99mTc-tetrofosmin SPECT of the chest to evaluate the value of 99mTc-tetrofosmin SPECT for detecting malignant and benign lesions.. Only 61% of the lung malignancies were detected by 99mTc-tetrofosmin SPECT of the chest, including 53% of epidermoid carcinoma (ca), 67% of adeno ca, 75% of small-cell ca, 0% of undifferentiated large-cell ca and 100% of other lung malignancies. In addition, 50% of the benign lesions were detected by chest 99mTc-tetrofosmin SPECT. The probability of tetrofosmin uptake in the mass was not related to mass size. The diagnostic sensitivity, specificity and accuracy were 61%, 50% and 59%, respectively, for differentiating malignant and benign lesions when diagnosing a single solid lung mass.. Technetium-99m-tetrofosmin SPECT of the chest is of little or no value for the detection of lung ca from single solid lung masses.

Topics: Adenocarcinoma; Adult; Aged; Aged, 80 and over; Carcinoma, Small Cell; Carcinoma, Squamous Cell; Female; Humans; Lung Diseases; Lung Neoplasms; Male; Middle Aged; Organophosphorus Compounds; Organotechnetium Compounds; Radiopharmaceuticals; Sensitivity and Specificity; Tomography, Emission-Computed, Single-Photon

99Tcm-tetrofosmin planar imaging was performed in 30 patients with malignant and benign lung lesions. There were 21 cases of primary lung cancer (10 squamous cell, 5 small cell, 4 adenocarcinoma and 2 large cell) and 9 benign lung lesions (4 pneumonia, 3 tuberculosis, 1 infected bronchiectasis and 1 bronchiectasis obliterans). Anterior and posterior planar thorax images were obtained 30 min after the intravenous injection of 740 MBq (20 mCi) of 99Tcm-tetrofosmin. Visual and quantitative evaluations were performed. For the quantitative evaluation, regions of interest were drawn over the lesioned area (L) and over the contralateral non-lesioned area (N). Of 21 malignant primary lesions; 19 (90%) showed 99Tcm-tetrofosmin accumulation. Four (44%) of the nine benign lung lesions (3 cases of pneumonia and the one case of active tuberculosis) showed uptake. The mean L/N ratios for the malignant and benign lesions were 1.63 +/- 0.29 and 1.64 +/- 0.19, respectively. There were no significant differences (P > 0.05) in the L/N ratios of the malignant and benign lesions or the various histological types of cancer. In conclusion, 99Tcm-tetrofosmin was highly sensitive (90%) in detecting malignant lung lesions, but it had poor specificity (55%).

Topics: Adenocarcinoma; Adult; Aged; Bronchiectasis; Bronchiolitis Obliterans; Carcinoma, Large Cell; Carcinoma, Small Cell; Carcinoma, Squamous Cell; Evaluation Studies as Topic; Female; Humans; Lung Diseases; Lung Neoplasms; Male; Middle Aged; Organophosphorus Compounds; Organotechnetium Compounds; Pneumonia; Radionuclide Imaging; Radiopharmaceuticals; Sensitivity and Specificity; Tuberculosis, Pulmonary

We conducted a preliminary study of captation of the new radiopharmaceutical 99mTc-tetrofosmin in cases of primary carcinoma of the lung, analyzing the results of 5 cases studied before surgery with single photon emission tomography (SPECT) of the lung. The results obtained by imaging were compared with those from surgery. Tumor size ranged between 3.5 and 9 cm. In all cases the images showed that captation of the radiotracer by the neoplasm was satisfactory, leaving the area of the tumor clearly distinguishable from normal adjacent lung tissue and giving no signs of interference caused by absorption of 99mTc-tetrofosmin by contiguous structures (heart or liver). Based on these preliminary results we assert that SPECT of the lung using 99mTc-tetrofosmin may be useful in the clinical diagnosis of malignant lung tumors, although further research must determine to what extent the technique can be relied upon.

Topics: Adenocarcinoma; Aged; Aged, 80 and over; Carcinoma, Bronchogenic; Carcinoma, Large Cell; Carcinoma, Squamous Cell; Drug Evaluation; Female; Humans; Lung Neoplasms; Lymphatic Metastasis; Male; Middle Aged; Organophosphorus Compounds; Organotechnetium Compounds; Tomography, Emission-Computed, Single-Photon