氯化铊201单光子发射计算机断层扫描（201Tl-chloride SPECT）与锝99m甲氧基异丁基异腈单光子发射计算机断层扫描（99mTc-MIBI SPECT）在头颈部恶性肿瘤显像中的比较

Comparison of 201Tl-chloride SPECT with 99mtc-MIBI SPECT in the depiction of malignant head and neck tumors.

作者信息

Tomura Noriaki, Watanabe Osamu, Takahashi Satoshi, Sakuma Ikuo, Otani Takahiro, Nishin Toshiaki, Watarai Jiro

机构信息

Department of Radiology, Akita University School of Medicine, Hondo, Japan.

出版信息

Ann Nucl Med. 2006 Feb;20(2):107-14. doi: 10.1007/BF02985622.

DOI:10.1007/BF02985622

PMID:16615419

Abstract

OBJECTIVE

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.

METHODS

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.

RESULTS

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).

CONCLUSIONS

The present study qualitatively and quantitatively showed that 201Tl had higher accumulation in the tumor than 99mTc-MIBI in both early and delayed images.

摘要

目的

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。

方法

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。

结果

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）。