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Technetium-99m-sestamibi SPECT for the diagnosis and follow-up of nasopharyngeal carcinoma

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Abstract

This study was to investigate a better way to detect and differentiate primary, residual, recurrent nasopharyngeal carcinoma (NPC) lesions post-radiotherapy in patients with NPC by means of routine computed tomography (CT) in combination with 99Tcm-sestamibi single photon emission computed tomography (99Tcm-MIBI SPECT). Forty-eight patients with histologically confirmed primary NPC underwent 99Tcm-MIBI SPECT at the 3rd month before and after radiotherapy, and at the 6th month after radiotherapy. All patients had contemporaneous CT examinations. Histopathologic results and/or clinical follow-up data (over 18 months) were used as the golden standard for evaluating residual/recurrent lesions. The radioactive count ratio of nasopharynx to scalp was obtained as the MIBI uptake index (MUI). Receiver operating characteristic analysis was employed to define the cut-off value of MUI for malignancy.With MUI 2.15 as the cut-off point, the accuracy for detecting primary NPC was 94.12%. The mean MUI in the local-regional of the nasopharynx in such negative cases was 1.21±0.12 at the 3rd month, while the mean MUI was higher in the other 15 patients with histologically confirmed recurrent/residual lesions (MUI = 1.40±0.16, t = 4.71, P < 0.001). The optimal cut-off point of 1.33 of MUI was defined with 89.58% accuracy for differentiating residual/recurrent lesions from the benign process post radiotherapy, while CT evaluations showed an accuracy of 81.25%. A combination of CT and 99Tcm-MIBI SPECT for 37 NPC patients with congruent results showed an accuracy of 97.30% for differentiating residual/recurrent NPC from benign lesions. 99Tcm-MIBI SPECT plays a role in evaluating residual/recurrent lesions post-radiotherapy. The combination of CT and 99Tcm-MIBI SPECT can give more accurate diagnosis in the follow-up of NPC.

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Authors and Affiliations

  1. Department of Nuclear Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China

    Jing Chen

  2. Department of Oncology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China

    Guang-Yuan Hu & Guo-Qing Hu

  3. Department of Nuclear Medicine, Xiamen First Hospital, Fujian Medical University, Xiamen, 361003, China

    Hua Wu

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  1. Jing Chen
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  2. Guang-Yuan Hu
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  4. Hua Wu
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Correspondence to Hua Wu.

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Chen, J., Hu, GY., Hu, GQ. et al. Technetium-99m-sestamibi SPECT for the diagnosis and follow-up of nasopharyngeal carcinoma. Front. Med. China 4, 96–100 (2010). https://doi.org/10.1007/s11684-010-0001-1

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  • DOI: https://doi.org/10.1007/s11684-010-0001-1

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