Evaluation of primary lung carcinoma using technetium 99m-hexamethylpropylene amine oxime: preliminary clinical experience.

99mTc-labelled hexamethylpropylene amine oxime (HMPAO) is a lipophilic compound with a neutral charge which reflects tumor blood flow and has been previously investigated to estimate brain blood flow. In this study, we attempted to use 99mTc-HMPAO for the evaluation of 18 patients with histologically proven primary lung carcinoma. The eight surgical specimens revealed that viable carcinoma cells were present when the 99mTc-HMPAO accumulated in the tumor, however, extensive tumor necrosis was observed when defective or ring like uptake was seen in the tumor. Qualitative study revealed that when perfusion defects were observed corresponding to the tumor, the possibility of squamous cell carcinoma or large cell carcinoma was high instead of adenocarcinoma. Quantitative analysis revealed that the uptake ratio was statistically different between adenocarcinoma (1.6 +/- 0.1) and squamous cell carcinoma (1.2 +/- 0.4) (P less than 0.05), between squamous cell carcinoma and large cell carcinoma (0.9 +/- 0.1) (P less than 0.05), and also between adenocarcinoma and large cell carcinoma (P less than 0.01). In conclusion, 99mTc-HMPAO may be useful for the evaluation of patients with primary lung carcinoma.