Single photon emission computed tomography using 201Tl chloride in pulmonary nodules: comparison with 67Ga citrate and 99mTc-labeled hexamethylpropyleneamine-oxime.
A single photon emission computed tomography (SPECT) with 201Tl chloride (Tl-201) was carried out prospectively in 50 patients with pulmonary nodules and its diagnostic value was compared with those of 67Ga citrate (Ga-67) and 99mTc-labeled hexamethylpropyleneamine-oxime (Tc-99m-HMPAO). Tl-201 SPECT provided 88% (early)-91% (delayed) sensitivity, 85% (early and delayed) specificity and 87% (early)-89% (delayed) accuracy. The sensitivity of the Tl-201 planar image was 56 (early)-62% (delayed), which was significantly lower than that of SPECT. Delayed SPECT images at 2 hour postinjection were more preferable to disclose the malignant pulmonary nodule than early SPECT images at 15 minutes postinjection. The application of SPECT with Ga-67 failed to improve the sensitivity of planar imaging for malignant pulmonary nodules. Tc-99m-HMPAO was concentrated in 62% of 13 patients with malignant pulmonary nodules, which was slightly higher than Ga-67 in 54% of 28 patients. In an analysis of the histologic types of lung cancer, the sensitivity of Tl-201 was not significantly different in all types. On the other hand, Ga-67 was positive only in 25% of 12 patients with adenocarcinoma. A combination of SPECT and Tl-201 is the best choice among routine scintigraphic techniques for depicting malignant pulmonary nodules. The Tl-201 SPECT image may play a complementary role in the characterization of pulmonary nodules which are revealed on a plain radiograph and computed tomography.
Itoh
K
K
Department of Nuclear Medicine, Hokkaido University School of Medicine, Sapporo, Japan.
Takekawa
H
H
Tsukamoto
E
E
Nagao
K
K
Nakada
K
K
Abe
S
S
Kawakami
Y
Y
Furudate
M
M
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D005710:Gallium Radioisotopes; D006801:Humans; D008175:Lung Neoplasms / Q000000981:diagnostic imaging*; D008297:Male; D008875:Middle Aged; D015609:Organotechnetium Compounds; D010091:Oximes; D012680:Sensitivity and Specificity; D019690:Technetium Tc 99m Exametazime; D013794:Thallium Radioisotopes; D015899:Tomography, Emission-Computed, Single-Photon
D005710:Gallium Radioisotopes; D015609:Organotechnetium Compounds; D010091:Oximes; D013794:Thallium Radioisotopes; D019690:Technetium Tc 99m Exametazime