technetium-tc-99m-tetrofosmin and Thoracic-Neoplasms

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

To evaluate the usefulness of 99mTc-tetrofosmin (TF) SPECT in the detection of intrathoracic malignant lesions, we studied 304 patients, 261 with malignant and 43 with benign lesions; 196 of the former had non-treated primary tumors, 193 lung cancer (LC) and 3 mesotheliomas, 11 had LC recurrences and 54 had metastases from different kinds of tumors. Twenty-nine patients with primary tumors were re-checked after chemotherapy or surgery. In all patients, after 740 MBq TF injection, both planar and SPECT images were acquired and analysed qualitatively, SPECT images also semiquantitatively. Scintigraphy was always compared to CT. SPECT showed higher sensitivity, specificity and accuracy values than CT (98.1, 90.7 and 97 vs. 96.2, 81.4, and 93.9%, respectively), their combined use achieving 100% sensitivity and 98.8% accuracy. Planar did not give more information than SPECT, showing a significantly lower sensitivity (63.2%) and accuracy (67.4%). SPECT showed higher accuracy values than CT and planar (86.9 vs. 78.3 and 69.6%) in NSCLC mediastinal lymph node staging. Moreover, SPECT was concordant with CT in correctly evaluating the response to chemotherapy or surgery in all monitorized primary tumors cases, except in one in whom only SPECT detected residual tumor. The semiquantitative analysis added useful information in differentiating malignant from benign lesions and in monitoring the response to chemo-therapy. TF SPECT appears a highly accurate diagnostic method in the detection of intrathoracic malignant lesions, in lungs and pleura, as well as in NSCLC mediastinal lymph node staging and in monitoring treatment effectiveness, playing a complementary role to CT in selected cases.

Topics: Adult; Aged; Aged, 80 and over; Carcinoma, Non-Small-Cell Lung; Combined Modality Therapy; False Negative Reactions; False Positive Reactions; Female; Humans; Lung Diseases; Lung Neoplasms; Lymphatic Metastasis; Male; Mesothelioma; Middle Aged; Neoplasm Recurrence, Local; Neoplasm, Residual; Organophosphorus Compounds; Organotechnetium Compounds; Pleural Neoplasms; Predictive Value of Tests; Radiopharmaceuticals; Sensitivity and Specificity; Thoracic Neoplasms; Tomography, Emission-Computed, Single-Photon; Tomography, X-Ray Computed; Treatment Outcome

This report describes the accurate localization of metastatic lesions in a patient with differentiated mixed thyroid cancer using 99mTc-tetrofosmin imaging. A 66-yr-old women with a cytological diagnosis of follicular thyroid cancer associated with a large amount of goiter changes was studied by 99mTc-tetrofosmin total-body scintigraphy. No significant tetrofosmin uptake was observed in the thyroid nodules, which mainly showed goiter abnormalities. Abnormal increased tetrofosmin uptake, however, was found in metastatic tumor lesions located in the cervical and dorsal spine as well as in the left lower chest wall and lungs. In conclusion, 99mTc-tetrofosmin, a new radiopharmaceutical proposed for myocardial perfusion imaging, may be useful in patients with thyroid cancer.

Topics: Aged; Carcinoma, Papillary, Follicular; Female; Humans; Lung Neoplasms; Organophosphorus Compounds; Organotechnetium Compounds; Radionuclide Imaging; Spinal Neoplasms; Thoracic Neoplasms; Thyroid Neoplasms