Yamamoto Yuka, Nishiyama Yoshihiro, Satoh Katashi, Ohbayashi Yumiko, Iwasaki Akinori, Miyabe Kazunori, Ohkawa Motoomi
Department of Radiology, Faculty of Medicine, Kagawa Medical University, Japan.
J Nucl Med. 2002 Nov;43(11):1464-8.
We examined mandibular invasion of intraoral squamous cell carcinoma by simultaneous bone and tumor dual-isotope SPECT using (99m)Tc-hydroxymethylene diphosphonate ((99m)Tc-HMDP) and (201)Tl-chloride ((201)Tl) and by CT.
Early and delayed simultaneous bone and tumor dual-isotope SPECT and CT were performed on 39 patients suspected of having tumor invasion of the mandible by intraoral squamous cell carcinoma. SPECT images were superimposed to project tumor location from tumor SPECT onto the osseous structures shown by bone SPECT. The CT imaging protocol consisted of 5-mm contiguous axial images.
Histopathologic examination revealed invasion of the mandible in 13 patients and no tumor invasion in 26 patients. The results of delayed dual-isotope SPECT were exactly the same as those of early dual-isotope SPECT. On early and delayed dual-isotope SPECT, the sensitivity, specificity, and accuracy in detecting mandibular invasion by intraoral squamous cell carcinoma were 100% (13/13), 88.5% (23/26), and 92.3% (36/39), respectively. The corresponding values using CT were 45.5% (5/11), 94.7% (18/19), and 76.7% (23/30), respectively, when 9 patients were excluded because of dental artifacts.
Our results suggest that superimposed early bone and tumor dual-isotope SPECT images alone may be sufficient in the diagnostic evaluation of mandibular invasion by intraoral squamous cell carcinoma.
我们使用（99m）锝-羟亚甲基二膦酸盐（（99m）Tc-HMDP）和（201）铊-氯化物（（201）Tl）通过同时进行骨与肿瘤双同位素SPECT以及CT来检查口腔鳞状细胞癌的下颌骨侵犯情况。
对39例疑似口腔鳞状细胞癌侵犯下颌骨的患者进行早期和延迟的骨与肿瘤双同位素SPECT及CT检查。将SPECT图像叠加，以便把肿瘤SPECT显示的肿瘤位置投影到骨SPECT所示的骨结构上。CT成像方案包括5毫米连续轴向图像。
组织病理学检查显示下颌骨侵犯的有13例患者，无肿瘤侵犯的有26例患者。延迟双同位素SPECT的结果与早期双同位素SPECT的结果完全相同。在早期和延迟双同位素SPECT上，检测口腔鳞状细胞癌下颌骨侵犯的敏感性、特异性和准确性分别为100%（13/13）、88.5%（23/26）和92.3%（36/39）。因牙齿伪影排除9例患者后，使用CT时的相应值分别为45.5%（5/11）、94.7%（18/19）和76.7%（23/30）。
我们的结果表明单独叠加早期骨与肿瘤双同位素SPECT图像可能足以用于口腔鳞状细胞癌下颌骨侵犯的诊断评估。
