Plotkin Michail, Wurm Reinhard, Kuczer David, Wust Peter, Michel Roger, Denecke Timm, Ruf Juri, Schlenger Lorenz, Bischoff Annet, Felix Roland, Amthauer Holger
Department of Radiology, Nuclear Medicine and Radiooncology, Campus Virchow, Berlin, Germany.
Onkologie. 2006 Apr;29(4):147-52. doi: 10.1159/000092025. Epub 2006 Mar 29.
Nuclear medicine imaging is increasingly used in the evaluation of tumors of the head and neck. In the current study, we assess the value of single-photon emission tomography (SPECT) using the amino acid tracer L-3-[123I]iodine-alpha-methyl-tyrosine (IMT) for the detection of recurrent head and neck cancer.
45 consecutive patients with suspected recurrence of previously treated head and neck cancer were examined by IMT-SPECT using a dual head system with integrated low-dose computed tomography (CT). The accuracy of the IMT-SPECT was evaluated by correlating the findings with results of histology or clinical and CT/MRI (magnetic resonance imaging) follow-up examinations.
The sensitivity, specificity and accuracy of IMT-SPECT in the detection of recurrent/persistent tumors were 83, 89 and 84.5%, respectively. The positive and negative predictive value amounted to 96.5 and 60%, respectively.
IMT-SPECT using integrated low-dose CT appears to be a helpful complementary imaging tool for the detection of local recurrences and lymph node metastases of head and neck cancer and their differentiation from treatment-induced changes. The advantage of the method is the high positive predictive value in the diagnosis of relapsed tumors. However, a negative IMT-SPECT result does not exclude a recurrence.
