Gregor R T, Valdés-Olmos R, Koops W, Balm A J, Hilgers F J, Hoefnagel C A
Department of Otolaryngology-Head and Neck Surgery, The Netherlands Cancer Institute, Antoni van Leeuwenhoek Hospital, Amsterdam.
Arch Otolaryngol Head Neck Surg. 1996 May;122(5):509-14. doi: 10.1001/archotol.1996.01890170043009.
To test the feasibility of single-photon emission computed tomography (SPECT) scanning with the use of thallous chloride T1 201 in patients with head and neck cancer and to decide its possible applications to improve the diagnosis and staging of head and neck cancer.
Findings from SPECT with the use of 4.32 mCi of thallous chloride T1 201 were compared with those from clinical examination, computed tomography (CT), magnetic resonance imaging, ultrasound-guided fine-needle aspiration, and histologic studies. Primary sites and neck nodes were separately studied. Accuracy, sensitivity, and specifically were calculated for 19 patients who were being assessed for initial treatment (primary sites) and for 12 neck node dissections in 10 patients.
The Netherlands Cancer Institute, Antoni van Leeuwenhoek Hospital, Amsterdam.
A consecutive sample of 25 patients with head and neck cancers of different sites. The average age of the patients was 60.2 years, and there were 19 men and six women. The sites of the primary lesions were as follows: oropharynx (n = 5), larynx (n = 9), oral cavity (n = 4), nasopharynx (n = 1), hypopharynx (n = 3), and unknown (n = 3).
For the primary lesions, SPECT identified 94% of the lesions; SPECT was more accurate in delineating four oropharyngeal lesions and one nasopharyngeal lesion. In 12 neck node dissections, SPECT identified all of the positive lesions and two negative lesions, whereas CT detected two false-positive lesions. Single-photon emission computed tomography gave less information about the number of nodes and the anatomy than did CT or magnetic resonance imaging.
Single-photon emission computed tomography with the use of thallous chloride T1 201 appears to be useful in helping to identify occult primary lesions, particularly in the oropharynx. It may assist CT or magnetic resonance imaging in identifying a recurrence of cancer in tissues or in lymph nodes, and in screening for distant metastases. Although no nodes were identified that were not already seen with the use of CT or magnetic resonance imaging, SPECT may help to eliminate the false-positive lesions, and SPECT with the use of thallous chloride T1 201 appears to be a valuable new tool in helping to diagnose and stage head and neck cancer.
检测使用氯化亚铊T1 201进行单光子发射计算机断层扫描（SPECT）在头颈癌患者中的可行性，并确定其在改善头颈癌诊断和分期方面的可能应用。
将使用4.32毫居里氯化亚铊T1 201进行SPECT的结果与临床检查、计算机断层扫描（CT）、磁共振成像、超声引导下细针穿刺及组织学研究的结果进行比较。分别对头颈部原发部位和颈部淋巴结进行研究。计算了19例接受初始治疗评估（原发部位）的患者以及10例患者中12次颈部淋巴结清扫的准确性、敏感性和特异性。
荷兰癌症研究所，阿姆斯特丹安东尼·范·列文虎克医院。
连续选取25例不同部位头颈癌患者。患者平均年龄60.2岁，男性19例，女性6例。原发病变部位如下：口咽（n = 5）、喉（n = 9）、口腔（n = 4）、鼻咽（n = 1）、下咽（n = 3）及不明部位（n = 3）。
对于原发病变，SPECT识别出94%的病变；SPECT在描绘4例口咽病变和1例鼻咽病变方面更准确。在12次颈部淋巴结清扫中，SPECT识别出所有阳性病变和2例阴性病变，而CT检测到2例假阳性病变。与CT或磁共振成像相比，单光子发射计算机断层扫描提供的关于淋巴结数量和解剖结构的信息较少。
使用氯化亚铊T1 201进行单光子发射计算机断层扫描似乎有助于识别隐匿性原发病变，尤其是在口咽部位。它可能有助于CT或磁共振成像识别组织或淋巴结中的癌症复发，并筛查远处转移。虽然未发现使用CT或磁共振成像未显示的淋巴结，但SPECT可能有助于消除假阳性病变，且使用氯化亚铊T1 201进行SPECT似乎是帮助诊断和分期头颈癌的一种有价值的新工具。
