Medical Oncology

, Volume 20, Issue 3, pp 247–253 | Cite as

Using technetium-99m methoxyisobutylisonitrile lung single-photon-emission computed tomography to predict response to chemotherapy and compare with p-glycoprotein expression in patients with untreted small cell lung cancer

  • Sheng-Pin Changlai
  • Chang-Shu Tsai
  • Hueisch-Jy Ding
  • Wen-Tao Huang
  • Albert Kao
  • Wu-Huei HsuEmail author
Original Article


The purpose of this study was to predict chemotherapy response by technetium-99m methoxy-isobutylisonitrile (Tc-99m MIBI) lung single-photon-emission computed tomography (SPECT) and compare P-glycoprotein (Pgp) expression in patients with untreated small cell lung cancer (SCLC). Before chemotherapy, 40 patients with untreated SCLC underwent Tc-99m MIBI lung SPECT. Immunohistochemical analyses were performed using multiple nonconsecutive sections of the biopsy specimens to detect Pgp expression. Chemotherapy response was evaluated in the third month after completion of treatment by clinical and radiological methods. Based on quantitative analyses, the tumor uptake ratios (TUR) of the 20 patients with good response (1.89±0.28) were significantly higher than that of the 20 patients with poor response (1.21±0.28) (p value<0.05). Based on visual interpretation, all of the 20 patients (100%) with good response had positive Tc-99m TF lung SPECT findings and negative Pgp expression. Five of the other 20 patients (25%) with poor response had positive Tc-99m MIBI lung SPECT findings, and 12 of the other 20 patients (60%) with poor response had negative Pgp expression (p value<0.05). Negative Tc-99m MIBI lung SPECT findings could predict poor response. Therefore, we concluded that Tc-99m MIBI lung SPECT can accurately predict the chemotherapy response, and Tc-99m MIBI lung SPECT findings can be partially compatible with Pgp expression in patients with untreated SCLC.

Key Words

Technetium-99m methoxyisobutylisonitrile single-photon-emission computed tomography small cell lung cancer chemotherapy P-glycoprotein 


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  1. 1.
    Lassen U, Hansen HH: Small cell carcinoma of the lung. In Cancer treatment, edited by CM Haskell, JS Berek, Philadelphia, W B Saunders, 1995, pp. 414–420.Google Scholar
  2. 2.
    Smit EF, Postmus PE: Chemotherapy of small cell lung cancer. In Carney DN (ed). Lung cancer. The Bath Press, Avon, London, 1995, pp. 156–172.Google Scholar
  3. 3.
    Berlin J, Schiller JH: Chemotherapy of small-cell carcinoma of the lung. In Johnson BE, Johnson DH (eds). Lung cancer. Wiley-Liss, New York, 1995, pp. 247–261.Google Scholar
  4. 4.
    Oka M, et al. The clinical role of MDR1 gene expression in human lung cancer. Anticancer Res 1997;17:721–724.PubMedGoogle Scholar
  5. 5.
    Twentyman PR. Mechanism of drug resistance in lung cancer cells. In Carney DN (ed). Lung cancer. The Bath Press, Avon, London. 1995.Google Scholar
  6. 6.
    Beck W, Dalton WS: Mechanisms of drug resistance. In DeVita VT Jr, et al. (eds.) Cancer: principles and practice of oncology. JB Lippincott, Philadelphia, 1997.Google Scholar
  7. 7.
    Piwnica-Worms D, et al. Functional imaging of multidrug-resistant P-glycoprotein with an organotechnetium complex. Cancer Res 1993;53:977–984.PubMedGoogle Scholar
  8. 8.
    Hendrikse NH, et al. Visualization of multidrug resistance in vivo. Eur J Nucl Med 1999;26:283–293.PubMedCrossRefGoogle Scholar
  9. 9.
    Vergote J, et al. Comparison of the kinetics of active efflux of 99mTc-MIBI in cells with P-glycoprotein-mediated and multidrug-resistance protein-associated multidrug-resistance phenotypes. Eur J Biochem 1998;252:140–146.PubMedCrossRefGoogle Scholar
  10. 10.
    Hendrikse NH, et al. 99mTc-sestamibi is a substrate for P-glycoprotein and the multidrug resistance-associated protein. Br J Cancer 1998;77:353–358.PubMedGoogle Scholar
  11. 11.
    Yamamoto Y, et al. Comparative study of technetium-99m-sestamibi and thallium-201 SPECT in predicting chemotherapeutic response in small cell lung cancer. J Nucl Med 1998;39:1626–1629.PubMedGoogle Scholar
  12. 12.
    Kao CH, et al. Technetium-99m methoxyisobutylisonitrile chest imaging of sinall cell lung carcinoma: relation to patient prognosis and chemotherapy response—a preliminary report. Cancer 1998;83:64–68.PubMedCrossRefGoogle Scholar
  13. 13.
    Kao CH, et al. Quickly predicting chemotherapy response to paclitaxel-based therapy in non-small cell lung cancer by early technetium-99m methoxyisobutylisonitrile chest single photon emission computed tomography. Clin Cancer Res 2000;6:820–824.PubMedGoogle Scholar
  14. 14.
    Oken MM, et al. Toxicity and response criteria of the Eastern Cooperative Oncology Group. Am J Clin Oncol 1982;5:649–655.PubMedCrossRefGoogle Scholar
  15. 15.
    Aktolun C, et al. Assessment of tumour necrosis and detection of mediastinal lymph node metastasis in bronchial carcinoma with technetium-99m MIBI imaging: comparison with CT scan. Eur J Nucl Med 1994;21:973–979.PubMedGoogle Scholar
  16. 16.
    Kao CH, et al. Differentiation of single solid lesions in the lungs by means of single-photon emission tomography with technetium-99m methoxyisobutylisonitrile. Eur J Nucl Med 1993;20:249–254.PubMedGoogle Scholar
  17. 17.
    Kostakoglu L, et al. Association of tumor washout rates and accumulation of technetium-99m-MIBI with expression of P-glycoprotein in lung cancer. J Nucl Med 1998;39:228–234.PubMedGoogle Scholar
  18. 18.
    Kreisholt J, et al. Immunohistochemical defection of DNA topoisomerases II α, p-glycoprotein and multidrug resistance protein (MRP) in small-cell and non-small-cell lung cancer. Br J Cancer 1998;77:1469–1473.PubMedGoogle Scholar
  19. 19.
    Chuman Y, et al. Expression of the multidrug-resistance-associated protein (MRP) gene in human colorectal, gastric and non-small-cell lung carcinomas. Int J Cancer 1996;66:274–279.PubMedCrossRefGoogle Scholar
  20. 20.
    Karnofsky DA, et al. The use of nitrogen mustards in the palliative treatment of cancer. Cancer 1948;1:634–656.CrossRefGoogle Scholar
  21. 21.
    Neal AJ, Hoskin PJ: Lung cancer and mesothelioma. In Neal AJ, Hoskin PJ (eds). Clinical oncology: basic principles and practice. Arnold, London, 1997, pp. 42–55.Google Scholar
  22. 22.
    Canitrot Y, et al. Multidrug resistance genes (MRP) and MDRI expression in small cell lung cancer xenografts: relationship with response to chemotherapy. Cancer Lett 1998;130:133–141.PubMedCrossRefGoogle Scholar

Copyright information

© Humana Press Inc 2003

Authors and Affiliations

  • Sheng-Pin Changlai
    • 1
  • Chang-Shu Tsai
    • 2
  • Hueisch-Jy Ding
    • 3
  • Wen-Tao Huang
    • 4
  • Albert Kao
    • 5
  • Wu-Huei Hsu
    • 6
    Email author
  1. 1.Department of RadiologyChi-Mei Medical CenterTainan
  2. 2.Tzu-Chi College of TechnologyHualien
  3. 3.School of Medical Radiation TechnologyI-Shou UniversityKaohsiung
  4. 4.Department of Radiological TechnologyYuanpei University of Science and TechnologyHsinchu
  5. 5.Department of Medical ResearchChina Medical University HospitalTaichungTaiwan
  6. 6.Division of Pulmonary and Critical Care Medicine, Department of MedicineChina Medical University HospitalTaichungTaiwan

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