Tomura Noriaki, Watanabe Osamu, Takahashi Satoshi, Sakuma Ikuo, Otani Takahiro, Nishin Toshiaki, Watarai Jiro
Department of Radiology, Akita University School of Medicine, Hondo, Japan.
Ann Nucl Med. 2006 Feb;20(2):107-14. doi: 10.1007/BF02985622.
Comparison of 201Tl chloride SPECT (TI-SPECT) with 99mTc-MIBI SPECT (MIBI-SPECT) in the depiction of malignant head and neck tumors was prospectively studied.
Forty-one patients with various tumors of the head and neck were included in this prospective study. Histologically, 36 patients had squamous cell carcinomas, 3 undifferentiated carcinomas, 1 transitional cell carcinoma, and 1 MALT lymphoma. All patients underwent a simultaneous dual-isotope SPECT of the head and neck with 201Tl and 99mTc-MIBI. Dual-isotope SPECT for early (n=41) and delayed acquisition (n=21) was performed. Qualitatively, 3 observers evaluated both TI-SPECT and MIBI-SPECT individually. The interpretation criteria were graded as grade 1 (no abnormal increased uptake) to 5 (definitely increased uptake of a degree equal to or greater than that of normal salivary gland). Statistical analysis of the comparison of Tl-SPECT and MIBI-SPECT was performed. The interobserver difference was evaluated using the kappa-coefficient. Quantitatively, T/N ratio (the ratio of the counts in the tumor divided by that in the normal nuchal muscles) and retention index were compared between TI-SPECT and MIBI-SPECT.
On both the early and delayed images, the grades of uptake of the tumor in TI-SPECT were significantly higher than those in MIBI-SPECT by three observers. The grade of Tl-uptake of the tumor on the delayed images was 5 for all observers (kappa-coefficient=1); however, the kappa-coefficient varied from 0.39 to 0.84 in early T1-SPECT, and in early and delayed MIBI-SPECT. Statistical differences in T/N ratio were noted between early TI-SPECT (2.87 +/- 1.19) and MIBI-SPECT (2.48 +/- 1.06), and between delayed Tl-SPECT (2.11 +/- 0.70) and MIBI-SPECT (1.20 +/- 0.48). The retention index or Tl-SPECT (0.81 +/- 0.24) was significantly higher than that of MIBI-SPECT (0.52 +/- 0.15).
The present study qualitatively and quantitatively showed that 201Tl had higher accumulation in the tumor than 99mTc-MIBI in both early and delayed images.
前瞻性研究氯化铊单光子发射计算机断层扫描（TI-SPECT）与锝-99m 甲氧基异丁基异腈单光子发射计算机断层扫描（MIBI-SPECT）在头颈部恶性肿瘤显像中的比较。
41 例患有各种头颈部肿瘤的患者纳入本前瞻性研究。组织学上，36 例为鳞状细胞癌，3 例为未分化癌，1 例为移行细胞癌，1 例为黏膜相关淋巴组织淋巴瘤。所有患者均接受了 201Tl 和 99mTc-MIBI 同时进行的头颈部双同位素单光子发射计算机断层扫描。进行了早期（n = 41）和延迟采集（n = 21）的双同位素单光子发射计算机断层扫描。定性方面，3 名观察者分别对 TI-SPECT 和 MIBI-SPECT 进行评估。解释标准分为 1 级（无异常摄取增加）至 5 级（摄取明显增加，程度等于或大于正常唾液腺）。对 Tl-SPECT 和 MIBI-SPECT 的比较进行了统计分析。使用kappa 系数评估观察者间差异。定量方面，比较了 TI-SPECT 和 MIBI-SPECT 之间的 T/N 比值（肿瘤计数与正常颈部肌肉计数之比）和滞留指数。
在早期和延迟图像上，3 名观察者均发现 TI-SPECT 中肿瘤的摄取等级明显高于 MIBI-SPECT。所有观察者在延迟图像上肿瘤的 Tl 摄取等级均为 5 级（kappa 系数 = 1）；然而，早期 T1-SPECT 以及早期和延迟 MIBI-SPECT 中的 kappa 系数在 0.39 至 0.84 之间变化。早期 TI-SPECT（2.87 ± 1.19）与 MIBI-SPECT（2.48 ± 1.06）之间以及延迟 Tl-SPECT（2.11 ± 0.70）与 MIBI-SPECT（1.20 ± 0.48）之间的 T/N 比值存在统计学差异。TI-SPECT 的滞留指数（0.81 ± 0.24）明显高于 MIBI-SPECT（0.52 ± 0.15）。
本研究在定性和定量方面均显示，在早期和延迟图像中，201Tl 在肿瘤中的蓄积均高于锝-99m 甲氧基异丁基异腈。
