Skip to main content
SpringerLink
Log in

Tc-99m MIBI SPECT in prediction of prognosis in patients with small cell lung cancer

  • Original Article
  • Published:
Annals of Nuclear Medicine Aims and scope Submit manuscript

Abstract

Purpose

The purpose of this study was to evaluate whether the degree of technetium-99m methoxyisobutylisonitrile (MIBI) uptake and its retention in delayed imaging in small cell lung cancer (SCLC) was correlated with the response to multiagent chemotherapy and to investigate if there was a relationship between the survival time of patients with SCLC and Tc-99m MIBI SPECT tumor uptake parameters at the time of diagnosis.

Methods

Between 1998 and by December 2004, 40 patients with SCLC were studied with Tc-99m MIBI SPECT at the time of diagnosis. The patients were classified by a follow-up CT as good responders (complete or partial remission) and poor responders (stable disease or progressive disease). Following i.v. administration of 740 MBq Tc-99m MIBI, SPECT imaging at 30 minutes (early) and 2 hours (delayed) was performed. Regions of interests were placed over the tumors and contralateral normal lung tissue on one transverse section. The uptake ratio of the lesion to that in the contralateral normal lung was obtained from early images (early ratio; ER) as well as delayed images (delayed ratio; DR). The retention index (RI%) was measured as: RI% = [(DR - ER)/ER] x 100. Tc-99m MIBI tumor uptake parameters were compared with chemotherapeutic response and survival time.

Results

Of 40 patients, 29 patients were good responders (72.5%) and 11 patients were poor responders (27.5%). RI% of Tc-99m MIBI SPECT in the group of good response was significantly higher than in that with poor response (p < 0.05). On the other hand, there was no significant difference between the two groups with respect to ER or DR values. Four of 40 patients were still alive with disease (10%). The patient survival time varied from 1 to 70 months (mean survival time = 12.9 ± 13.4 months). There was no significant difference between the survival time of patients with respect to ER or DR of Tc-99m MIBI SPECT imaging. When median RI% was accepted as a cut-off value (-3.85%), patients with higher RI% values had a longer survival time (12 months) when compared with those with low RI% (8 months), p < 0.05.

Conclusion

Our results suggest that Tc-99m MIBI SPECT could accurately predict the chemotherapy response in patients with SCLC. RI% of Tc-99m MIBI SPECT is recommended to differentiate patients with a poor response to chemotherapy and good responders, and RI% of Tc-99m MIBI SPECT appears as the only parameter that may be useful in predicting the survival of patients with SCLC.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Hoffmann PC, Mauer AM, Vokes Everett E. Lung Cancer.The Lancet 2000; 355: 479–485.

    Google Scholar 

  2. Spiro SG, Porter JC. Lung cancer-Where are we today?American Journal of Respiratory and Critical Care Medicine 2002; 166: 1166–1196.

    Article  PubMed  Google Scholar 

  3. Brock I, Hipfner DR, Nielsen BS, Jensen PB, Deeley RG, Cole SP, et al. Sequential coexpression of the multidrug resistance gene MRP and mdrl and their products in products in VP-16 (Etoposide)-selected H69 small cell lung cancer.Cancer Res 1995; 55: 459–462.

    PubMed  CAS  Google Scholar 

  4. Narasaki F, Matsuo I, Ikuno N, Fukuda M, Soda H, Oka M. Multidrug resistance-associated protein (MRP) gene expression in human lung cancer.Anticancer Res 1996; 16: 2079–2082.

    PubMed  CAS  Google Scholar 

  5. Hendrikse NH, Fransseen EJF, Van der Graaf WTA, Vaalburg W, Vries de EGE. Visualization of multidrug resistancein vivo.Eur J Nud Med 1999; 26: 283–293.

    Article  CAS  Google Scholar 

  6. Moretti JL, Caglar M, Boaziz C, Caillat-Vigneron M, Morere JF. Sequential functional imaging with technetium-99m hexakis-2-methoxyisobutylisonitrile and indium-111 octreotide: can we predict the response to chemotherapy in small cell lung cancer?Eur J Nucl Med 1995; 22: 177–180.

    Article  PubMed  CAS  Google Scholar 

  7. Kao CH, ChangLai SP, Chieng PU, Yen TC. Technetium-99m methoxyisobutylisonitrile chest imaging of small cell lung carcinoma.Cancer 1998; 83: 64–68.

    Article  PubMed  CAS  Google Scholar 

  8. Canitrot Y, Bichat F, Cole SP, Deeley RG, Gerlach JH, Bastian G, et al. Multidrug resistance genes (MRP) and MDR1 expression in small cell lung cancer xenografts: relationship with response to chemotherapy.Cancer Lett 1998; 130: 133–141.

    Article  PubMed  CAS  Google Scholar 

  9. Shiau YC, Tsai SC, Wang JJ, Ho YJ, Ho ST, Kao CH. To predict chemotherapy response using technetium-99m tetrofosmin and compare with p-glycoprotein and multidrug resistance related protein-1 expression in patients with untreated small cell lung cancer.Cancer Lett 2001; 169: 181–188.

    Article  PubMed  CAS  Google Scholar 

  10. Chiu ML, Kronauge JF, Piwnica-Worms D. Effect of mito-chondrial and plasma membrane potentials on accumulation of hexakis (2-methoxy isobutyl isonitrile) Tc-99m cultured mouse fibroblast.J Nucl Med 1990; 31: 1646–1653.

    PubMed  CAS  Google Scholar 

  11. Piwnica-Worms D, Kronauge JF, Chiu ML. Uptake and retention of hexakis (2-methoxyisobutylisonitrile) techne-tium (I) in cultured chick myocardial cells: mitochondrial and plasma membrane potential difference.Circulation 1990; 82: 1826–1838.

    PubMed  CAS  Google Scholar 

  12. Kuo TH, Liu FY, Chuang CY, Wu HS, Wang JJ, Kao A. To predict response chemotherapy using technetium-99m tetrofosmin chest images in patients with untreated small cell lung cancer and compare with p-glycoprotein, multidrug resistance related protein-l, and lung resistance-related protein expression.Nucl Med Biol 2003; 30: 627–632.

    Article  PubMed  CAS  Google Scholar 

  13. Fukumoto M, Yoshida D, Hayase N, Kurohara A, Akagi N, Yoshida S. Scintigraphic prediction of resistance to radiation and chemotherapy in patients with lung carcinoma.Cancer 1999; 86: 1470–1479.

    Article  PubMed  CAS  Google Scholar 

  14. Nishiyama Y, Yamamoto Y, Satoh K, Ohkawa M, Kameyama K, Hayashi E, et al. Comparative study of Tc-99m MIBI and Tl-201 SPECT in predicting chemo-therapeutic response in non-small-cell lung cancer.Clin Nucl Med 2000; 25: 364–369.

    Article  PubMed  CAS  Google Scholar 

  15. Yamamoto Y, Nishiyama Y, Satoh K, Takashima H, Ohkawa M, Fujita J, et al. Comparative study of technetium-99m-sestamibi and thallium-201 SPECT in predicting chemo-therapeutic response in small cell lung cancer.J Nucl Med 1998; 39: 1626–1629.

    PubMed  CAS  Google Scholar 

  16. Bom HS, Kim YC, Song HC, Min JJ, Kim JY, Park KO. Technetium-99m-MIBI uptake in small cell lung cancer.J Nucl Med 1998; 39: 91–94.

    PubMed  CAS  Google Scholar 

  17. Ciarmiello A, Del Vecchio S, Silvestro P, Potena MI, Carriero MV, Thomas R, et al. Tumor clearance of techne-tium-99m sestamibi as a predictor of response to neoadjuvant chemotherapy for locally advanced breast cancer.J Clin Oncol 1998; 16: 1677–1683.

    PubMed  CAS  Google Scholar 

  18. Del Vecchio S, Ciarmiello A, Pace L, Potena MI, Carriero MV, Mainolfi C, et al. Fractional retention of technetium-99m sestamibi as an index of P-glycoprotein expression in untreated breast cancer patients.J Nucl Med 1997; 38: 1348–1351.

    Google Scholar 

  19. Burak Z, Ersoy O, Moretti JL, Erinç R, Özcan Z, Dirlik A, et al. The role Tc-99m MIBI scintigraphy in the assessment of MDR1 overexpression in patients with musculoskeletal sarcomas: comparison with therapy response.Eur J Nucl Med 2001; 28: 1341–1350.

    Article  PubMed  CAS  Google Scholar 

  20. Budinger TF. Physical attributes of single-photon tomography.J Nucl Med 1980; 21: 579–592.

    PubMed  CAS  Google Scholar 

  21. Moorin RE, Davison A, Turner JH. Optimization of techne-tium-99m sestamibi single-photon emission tomography to define multidrug resistance with confidence.Nucl Med Commun 2004; 25: 1039–1048.

    Article  PubMed  CAS  Google Scholar 

  22. Moretti JL, Azaloux H, Boisseron D, Kouyoumdjian JC, Vilcoq J. Primary breast cancer imaging with technetium-99m sestamibi an its relation P-glycoprotein overexpression.Eur J Nucl Med 1996; 23: 980–986.

    Article  PubMed  CAS  Google Scholar 

  23. Del Vecchio S, Zannetti A, Aloj L, Caraco C, Ciarmiello A, Salvatore M. Inhibition of early99mTc-MIBI uptake by Bcl-2 anti-apoptotic protein overexpression in untreated breast carcinoma.Eur J Nucl Med Mol Imaging 2003; 30: 879–887.

    PubMed  CAS  Google Scholar 

  24. Komori T, Narabayashi I, Matsui R, Sueyoshi K, Aratani T, Utsunomiya K. Technetium-99m MIBI single photon emission computed tomography as a indicator of prognosis for patients with lung cancer-preliminary report.Ann Nucl Med 2000; 14: 415–420.

    Article  PubMed  CAS  Google Scholar 

  25. Yüksel M, Çerrnik TF, Doğanay L, Karhkaya C, Çakir E, Salan A, et al.99mTc-MIBI in non-small cell lung cancer in relationship with pgp and prognosis.Eur J Nucl Med 2002; 29: 876–881.

    Article  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Nuclear Medicine, Ege University School of Medicine, Bornova, 35100, Izmir, Turkey

    Aysegul Akgun, Inanc Karapolat & Zeynep Burak

  2. Departments of Pulmonary Medicine, Ege University School of Medicine, Izmir, Turkey

    Gursel Cok & Tuncay Goksel

Authors
  1. Aysegul Akgun
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Gursel Cok
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Inanc Karapolat
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Tuncay Goksel
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Zeynep Burak
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Aysegul Akgun.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Akgun, A., Cok, G., Karapolat, I. et al. Tc-99m MIBI SPECT in prediction of prognosis in patients with small cell lung cancer. Ann Nucl Med 20, 269–275 (2006). https://doi.org/10.1007/BF02984643

Download citation

  • Received:

  • Accepted:

  • Issue Date:

  • DOI: https://doi.org/10.1007/BF02984643

Key words

Search

Navigation