Evaluating benign and malignant bone and soft-tissue lesions with technetium-99m-MIBI scintigraphy.
This study compares the ability of 201TI and 99mTc-MIBI to detect and assess tumor response to chemotherapy in malignant and benign bone and soft-tissue lesions.


METHODS
Forty-two patients with various bone and soft-tissue pathologies (29 malignant and 13 benign lesions) were studied with 201TI and 99mTc-MIBI. Planar 201TI scintigraphy was performed 15 min after injection of 111 MBq of 201TI. Within 1 wk of the 201TI study, radionuclide angiography with 600-740 MBq of 99mTc-MIBI was performed and planar imaging was done 15 min later.


RESULTS
In visual analysis, 31 of 42 patients showed similar uptake of both tracers, 8 showed more intense uptake of 99mTc-MIBI than 201TI and 3 showed more intense uptake of 201TI than 99mTc-MIBI. In quantitative analysis, similar 201TI and 99mTc-MIBI uptake ratios were obtained (1.96 +/- 1.25 versus 1.96 +/- 1.02, respectively; p = ns). The perfusion index derived from 99mTc-MIBI radionuclide angiography was higher than 99mTc-MIBI uptake ratio (2.33 +/- 1.23 versus 1.96 +/- 1.02, respectively; p < 0.005), but correlated well with 99mTc-MIBI uptake ratio (r = 0.75). In 11 patients with malignant tumors, 201TI and 99mTc-MIBI scintigraphy was repeated after chemotherapy and the uptake of both tracers was significantly suppressed in patients with complete response confirmed by histological evaluation. In patients with complete response (n = 3), the uptake ratio of both tracers was reduced by more than 50%, whereas, less than 20% reduction of uptake ratio was observed in patients with nonresponse (n = 6).


CONCLUSIONS
The ability of 99mTc-MIBI to detect malignant and benign bone and soft-tissue lesions and to assess tumor response to chemotherapy was comparable to that of 201TI. In addition, blood flow could be assessed by radionuclide angiography with 99mTc-MIBI. Technetium-99m-MIBI is a promising radiopharmaceutical for the evaluation of bone and soft-tissue lesions.
Taki
J
J
Department of Nuclear Medicine, Kanazawa University School of Medicine, Japan.
Sumiya
H
H
Tsuchiya
H
H
Tomita
K
K
Nonomura
A
A
Tonami
N
N
D000038:Abscess / Q000000981:diagnostic imaging; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001847:Bone Diseases / Q000000981:diagnostic imaging; D001859:Bone Neoplasms / Q000000981:diagnostic imaging* / Q000188:drug therapy; D001842:Bone and Bones / Q000000981:diagnostic imaging; D002648:Child; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011875:Radionuclide Angiography; D012983:Soft Tissue Neoplasms / Q000000981:diagnostic imaging* / Q000188:drug therapy; D017256:Technetium Tc 99m Sestamibi; D013794:Thallium Radioisotopes
D013794:Thallium Radioisotopes; D017256:Technetium Tc 99m Sestamibi