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Combined SPECT/CT imaging using 123I-IMT in the detection of recurrent or persistent head and neck cancer

  • Nuclear Medicine
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Abstract

The aim of the study was to assess the clinical value of combined SPECT/CT imaging using L-3-[123I]iodine-α-methyl tyrosine (IMT) for the differential diagnosis of recurrences in patients pre-treated for head and neck cancer. Thirty-four consecutive patients with biopsy-proven carcinomas, who had previously been treated by surgery and/or radio/chemotherapy, were examined at our clinic by IMT-SPECT using a dual-head system with integrated low-dose CT. SPECT results were correlated with histopathology, clinical and CT/MRI follow-up data. In the follow-up after SPECT examination, the final diagnosis of recurrent tumour was established in 26 patients; the remaining eight patients were recurrence-free (follow-up >6 months). IMT-SPECT/CT correctly detected recurrent disease and/or neck lymph node metastases in 22 patients. In addition, distant metastases were displayed in two patients. The study was false-negative in four patients (sensitivity 85%). True-negative results were registered in seven patients, and false-positive in one patient. Image fusion with coregistered low-dose CT facilitates the localisation and interpretation of IMT-SPECT findings. IMT-SPECT using integrated low-dose CT is a promising non-invasive imaging tool for the detection of head and neck cancer recurrences and their differentiation from treatment-induced changes.

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References

  1. Myers E, Leffall L (1991) Head and neck oncology: diagnosis, treatment and rehabilitation. Little Brown, Boston

    Google Scholar 

  2. Bronstein AD, Nyberg DA, Schrarzt AN, Shuman WP, Griffin BR (1989) Soft-tissue changes after head and neck radiation: CT findings. Am J Neuroradiol 10:171–175

    Google Scholar 

  3. Som PM (1992) Detection of metastasis in cervical lymph nodes: CT and MR citeria and differential diagnosis. Am J Roentgenol 158:961–969

    CAS  Google Scholar 

  4. Chisin R (1999) Nuclear medicine in head and neck oncology: reality and perspectives. J Nucl Med 40:91–95

    Google Scholar 

  5. Davis JP, Maisey NM, Chevreton EB (1998) Positron emission tomography: a useful imaging technique for otolaryngology, head and neck surgery? J Laryngol Otol 112:125–127

    CAS  PubMed  Google Scholar 

  6. Baum U, Anders K, Steinbichler G, Lell M, Greess H, Riedel T, Kachelriess M, Kalender WA, Bautz WA (2004) Improvement of image quality of multislice spiral CT scans of the head and neck region using a raw data-based multidimensional adaptive filtering (MAF) technique. Eur Radiol 14:1873–1881

    Article  PubMed  Google Scholar 

  7. Lapela M, Grenman R, Kurki T, Joensuu H, Leskinen S, Lindholm P, Haaparanta M, Ruotsalainen U, Minn H (1995) Head and neck cancer: detection of recurrence with PET and 2-[F-18]fluoro-2-deoxy-D-glucose. Radiology 197:205–211

    CAS  PubMed  Google Scholar 

  8. Farber LA, Benard F, Machtay M, Smith RJ, Weber RS, Weinstein GS, Chalian AA, Alavi A, Rosenthal DI (1999) Detection of recurrent head and neck squamous cell carcinomas after radiation therapy with 2-18F-fluoro-2-deoxy-D-glucose positron emission tomography. Laryngoscope 109:970–975

    CAS  PubMed  Google Scholar 

  9. Fischbein NJ, AAssar OS, Caputo GR, Kaplan MJ, Singer MI, Price DC, Dillon WP, Hawkins RA (1998) Clinical utility of positron emission tomography with 18F-fluorodeoxyglucose in detecting residual/recurrent squamous cell carcinoma of the head and neck. Am J Neuroradiol 19:1189–1196

    CAS  PubMed  Google Scholar 

  10. Kao CH, ChangLai SP, Chieng PU, Yen RF, Yen TC (1998) Detection of recurrent or persistent nasopharyngeal carcinomas after radiotherapy with 18-fluoro-2-deoxyglucose positron emission tomography and comparison with computed tomography. J Clin Oncol 16:3550–3555

    CAS  PubMed  Google Scholar 

  11. Wong RJ, Lin DT, Schoder H, Patel SG, Gonen M, Wolden S, Pfister DG, Shah JP, Larson SM, Kraus DH (2002) Diagnostic and prognostic value of [(18)F]fluorodeoxyglucose positron emission tomography for recurrent head and neck squamous cell carcinoma. J Clin Oncol 20:4199–4208

    CAS  PubMed  Google Scholar 

  12. Yamada S, Kubota K, Kubota R, Ido T, Tamashashi N (1995) High accumulation of fluorine-fluorodeoxyglucose in terpentine-induced inflammatory tissue. J Nucl Med 36:1301–1306

    CAS  PubMed  Google Scholar 

  13. Reinhardt MJ, Kubota K, Yamada S, Iwata R, Yaegashi H (1997) Assessment of cancer recurrence in residual tumors after fractionated radiotherapy: a comparison of flouorodeoxyglucose, L-methionine and thymidine. J Nucl Med 38:280–287

    CAS  PubMed  Google Scholar 

  14. Hautzel H, Müller-Gärtner HW (1997) Early changes in fluorine-18-FDG uptake during radiotherapy. J Nucl Med 38:1384–1386

    CAS  PubMed  Google Scholar 

  15. Leskinen-Kallio S, Nagren K, Lehikoinen P, Ruotsalainen U, Teras M, Joensuu H (1992) Carbon-11-methionine and PET is an effective method to image head and neck cancer. J Nucl Med 33:691–695

    CAS  PubMed  Google Scholar 

  16. Lindholm P, Leskinen-Kallio S, Grenman R, Lehikoinen P, Nagren K, Teras M, Ruotsalainen U, Joensuu H (1995) Evaluation of response to therapy in head and neck cancer by positron emission tomography and [11C]methionine. Int J Radiat Oncol Biol Phys 32:787–794

    CAS  PubMed  Google Scholar 

  17. Nuutinen J, Jyrkkio S, Lehikoinen P, Lindholm P, Minn H (1999) Evaluation of early response to radiotherapy in head and neck cancer measured with [11C]methionine-positron emission tomography. Radiother Oncol 52:225–232

    CAS  PubMed  Google Scholar 

  18. Chesnay E, Babin E, Constans JM, Agostini D, Bequignon A, Regeasse A, Sobrio F, Moreau S (2003) Early response to chemotherapy in hypophyryngeal cancer: assessment with (11)C-methionine PET. Correlation with morphologic response, and clinical outcome. J Nucl Med 44:526–532

    CAS  PubMed  Google Scholar 

  19. Langen KJ, Coenen HH, Roosen N, Kling P, Muzik O, Herzog H, Kuwert T, Stöcklin G, Feinendegen LE (1990) SPECT studies of brain tumors with L-3-[123]iodo-a-methyltyrosine: comparison with PET, 124IMT and first clinical results. J Nucl Med 31:281–286

    CAS  PubMed  Google Scholar 

  20. Langen KJ, Ziemons K, Kiwit JCW, Herzog H, Kuwert T, Bock WJ, Stöcklin G, Feinendegen LE, Müller-Gärtner HW (1997) 3-[123I]iodo-alpha-methyltyrosine and [methyl-11C]-L-methionine uptake in cerebral gliomas: a comparative study using SPECT and PET. J Nucl Med 38:517–522

    CAS  PubMed  Google Scholar 

  21. Langen K-J, Pauleit D, Coenen HH (2002) 3-(123I)-Iodo-a-methyl-L-tyrosne: uptake mechanisms and clinical applications. Nucl Med Biol 29:625–631

    CAS  PubMed  Google Scholar 

  22. Dierickx LO, Everaert H, Deron P, Voordeckers M, Lahoutte T, Bossuyt A (2003) Evaluation of the response to therapy of head and neck squamous cell carcinoma by using 3-[123I]iodo-L-alpha-methyl tyrosine and single photon emission tomography. Nucl Med Commun 24:633–641

    CAS  PubMed  Google Scholar 

  23. Flamen P, Bernheim N, Deron P, Caveliers V, Chavatte K, Franken PR, Bossuyt A (1998) Iodine-123 alpha-methyl-l-tyrosine single-photon emission tomography for the visualization of head and neck squamous cell carcinomas. Eur J Nucl Med 25:177–181

    CAS  PubMed  Google Scholar 

  24. Dierickx LO, Lahoutte T, Deron P, Caveliers V, Vanhove C, Everaert H, Bossuyt A (2001) Diagnosis of recurrent head and neck squamous cell carcinoma with 3-[123I]iodo-L-alpha-methyltyrosine SPET. Eur J Nucl Med 28:282–287

    Google Scholar 

  25. Tomura N, Watanabe O, Omachi K, Sakuma I, Takahashi S, Otani T, Kidani H, Watarai J (2004) Image fusion of thallium-201 SPECT and MR imaging for the assessment of recurrent head and neck tumors following flap reconstructive surgery. Eur Radiol 14:1249–1254

    Google Scholar 

  26. Krummreich C, Holsbach M, Stöcklin G (1994) Direkt electrophilic radioiodination of tyrosine analogues: their in-vivo stability and brain uptake in mice. Appl Radiat Isotopes 45:929–935

    Article  Google Scholar 

  27. Biersack HJ, Coenen HH, Stocklin G, Reichmann K, Bockisch A, Oehr P, Kashab M, Rollmann O (1989) Imaging of brain tumors with L-3-[123I]iodo-α-methyl tyrosine and SPECT. J Nucl Med 30:110–112

    CAS  PubMed  Google Scholar 

  28. Samnick S, Bader JB, Hellwig D, Moringlane JR, Alexander C, Romeike BF, Feiden W, Kirsch CM (2002) Clinical value of iodine-123-alpha-methyl-L-tyrosine single-photon emission tomography in the differential diagnosis or recurrent brain tumor in patients pretreated for glioma at follow-up. J Clin Oncol 15:396–404

    Article  Google Scholar 

  29. Kuwert T, Woesler B, Morgenroth C, Lerch H, Schafers M, Palkovic S, Matheja P, Brandau W, Wassmann H, Schober O (1998) Diagnosis of recurrent glioma with SPECT and iodine-123-alpha-methyl tyrosine. J Nucl Med 39:23–27

    CAS  PubMed  Google Scholar 

  30. Matheja P, Weckesser M, Rickert C, Franzius C, Palkovic S, Riemann B, Schober O (2002) I-123-lodo-alpha-methyl tyrosine SPECT in non-parenchymal brain tumours. Nuklearmediziner 41:191–196

    CAS  Google Scholar 

  31. Plotkin M, Eisenacher J, Bruhn H, Wurm R, Michel R, Stockhammer R, Feußner A, Dudeck O, Wust P, Felix R, Amthauer H (2004) 123I-IMT SPECT and 1H MR-spectroscopy at 3.0 Tesla in the differential diagnosis of recurrent or residual gliomas: a comparative study. J Neuro-oncol 70:49–58

    Article  Google Scholar 

  32. Plotkin M, Amthauer H, Eisenacher J, Wurm R, Michel R, Wust R, Stockhammer F, Gutberlet M, Röttgen R, Ruf J, Felix R (2005) Value of 123I-IMT SPECT for diagnosis of recurrent non-astrocytic intracranial tumours. Neuroradiology 47:18–26

    PubMed  Google Scholar 

  33. Pauleit D, Floeth F, Tellmann L, Hamacher H, Hautzel H, Müller HW, Coenen HH, Langen KJ (2004) Comparison of O-(2-18F-fluoroethyl)-L-tyrosinePET and 3-123I-iodo-α-methyl-L-tyrosine SPECT in brain tumors. J Nucl Med 45:374–381

    CAS  PubMed  Google Scholar 

  34. Jager PL, Franssen EJ, Kool W, Szabo BG, Hoekstra HJ, Groen HJ, de Vries EG, van Imhoff GW, Vaalburg W, Piers DA (1998) Feasibility of tumor imaging using L-3-[iodine-123]-iodo-alpha-methyl-tyrosine in extracranial tumors. J Nucl Med 39:1736–1743

    CAS  PubMed  Google Scholar 

  35. Jager PL, Groen HJ, van der Leest A, van Putten JW, Pieterman RM, de Vries EG, Piers DA (2001) L-3-[123I]iodo-alpha-methyl-tyrosine SPECT in non-small cell lung cancer: preliminary observations. J Nucl Med 42:579–585

    CAS  PubMed  Google Scholar 

  36. Willkomm P, Bangard M, Guhlke S, Sartor J, Bender H, Gallkowski U, Reichmann K, Biersack HJ (2002) Comparison of [18F]FDG-PET and L-3[123I]-iodo-alpha-methyl tyrosine (I-123 IMT)-SPECT in primary lung cancer. Ann Nucl Med 16:503–506

    CAS  PubMed  Google Scholar 

  37. Jager PL, Plaat BE, de Vries EG, Molenaar WM, Vaalburg W, Piers DA, Hoekstra HJ (2000) Imaging of soft-tissue tumors using L-3-[iodine-123]iodo-alpha-methyl-tyrosine single photon emission computed tomography: comparison with proliferative and mitotic activity, cellularity, and vascularity. Clin Cancer Res 6:2252–2259

    CAS  PubMed  Google Scholar 

  38. Jager PL, Meijer WG, Kema IP, Willemse PH, Piers DA, de Vries EG (2000) L-3-[123I]Iodo-alpha-methyltyrosine scintigraphy in carcinoid tumors: correlation with biochemical activity and comparison with [111In-DTPA-D-Phe1]-octreotide imaging. J Nucl Med 41:1793–1800

    CAS  PubMed  Google Scholar 

  39. Steinert H, Boni R, Huch-Boni RA, Capaul R, von Schulthess GK, Westera G (1997) [123I]-alpha-methyltyrosine scintigraphy in malignant melanoma. Nuklearmediziner 36:36–41

    CAS  Google Scholar 

  40. Henze M, Mohammed A, Mier W, Rudat V, Dietz A, Nollert J, Eisenhut M, Haberkorn U (2002) Pretreatment evaluation of carcinomas of the hypopharynx and larynx with 18F-fluorodeoxyglucose, 123I-alpha-methyl-L-tyrosine and 99mTc-hexakis-2-methoxyisobutylisonitrile. Eur J Nucl Med Mol Imaging 29:324–330

    CAS  PubMed  Google Scholar 

  41. Ruf J, Lehmkuhl L, Bertram H, Sandrock D, Amthauer H, Humplik B, Munz DL, Felix R (2004) Impact of SPECT and integrated low-dose CT after radioiodine therapy on the management of patients with thyroid carcinoma. Nucl Med Commun 25:1177–1182

    PubMed  Google Scholar 

  42. Pfannenberg AC, Eschmann SM, Horger M, Lamberts R, Vonthein R, Claussen CD, Bares R (2003) Benefit of anatomical-functional image fusion in the diagnostic work-up of neuroendocrine neoplasms. Eur J Nucl Med Mol Imaging 30:835–843

    PubMed  Google Scholar 

  43. Kaczirek K, Prager G, Kienast O, Dobrozemsky G, Dudczak R, Niederle B, Kurtaran A (2003) Combined transmission and (99m)Tc-sestamibi emission tomography for localization of mediastinal parathyroid glands. Nuklearmediziner 42:220–223

    CAS  Google Scholar 

  44. Ozer S, Dobrozemsky G, Kienast O, Beheshti M, Becherer A, Niederle B, Kainberger F, Dudczak R, Kurtaran A (2004) Value of combined XCT/SPECT technology for avoiding false positive planar (123)I-MIBG scintigraphy. Nuklearmediziner 43:164–170

    CAS  Google Scholar 

  45. Schwartz LH, Ozsahin M, Zhang GN, Touboul E, De Vataire F, Andolenko P, Lacau-Saint-Guily J, Laugier A, Schlienger M (1994) Synchronous and metachronous head and neck carcinomas. Cancer 74:1933–1938

    CAS  PubMed  Google Scholar 

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Acknowledgements

Results of this study were partly presented at the 50th annual meeting of the Society of Nuclear Medicine in New Orleans (USA) in June 2003 and at the annual meeting of the European Association of Nuclear Medicine in Helsinki (Finland) in September 2004. The authors thank Gisela Keller for her assistance in preparing this study. Furthermore, the authors are very grateful to Professor Dr. Karl-Joseph Langen (Institute of Medicine, Research Centre Jülich) for valuable advises on data analysis.

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Authors and Affiliations

  1. Department of Radiology, Nuclear Medicine and Radiooncology, Campus Virchow, Berlin, Germany

    Michail Plotkin, Julia Eisenacher, Roger Michel, Maciej Pech, Timm Denecke, Roland Felix & Holger Amthauer

  2. Department of Radiation Therapy, Campus Mitte, Charité-Universitätsmedizin, Berlin, Germany

    Reinhard Wurm, Lorenz Schlenger, David Kuczer & Annet Bischoff

  3. Department of Radiology and Nuclear Medicine, Central Clinical Hospital of the Ministry of Internal Affairs and Administration, Warsaw, Poland

    Katarzyna Szerewicz

  4. Klinik für Strahlenheilkunde, Universitätsklinik Charité, Campus Virchow-Klinikum, Augustenburger Platz 1, 13353, Berlin, Germany

    Michail Plotkin

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  1. Michail Plotkin
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  2. Reinhard Wurm
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Correspondence to Michail Plotkin.

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Plotkin, M., Wurm, R., Eisenacher, J. et al. Combined SPECT/CT imaging using 123I-IMT in the detection of recurrent or persistent head and neck cancer. Eur Radiol 16, 503–511 (2006). https://doi.org/10.1007/s00330-005-2832-8

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  • DOI: https://doi.org/10.1007/s00330-005-2832-8

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