Detection of recurrent malignant melanoma with 99mTc-MIBI scintigraphy.
Initial reports suggest that 99mTc-methoxyisobutylisonitrile (MIBI) scanning may be of clinical value in staging patients with malignant melanoma. We carried out a study to evaluate the potential of this technique in the detection of recurrent disease. Whole-body 99mTC-MIBI scans were performed in 81 patients with a history of a surgically excised MM: 28 with known recurrent lesions and 53 during follow-up without evidence of disease. Images started 10 min post-injection, using a dose of 740 MBq. Diagnoses were confirmed by cytological/histological examination or at least one conventional imaging modality. Blinded interpretations of the MIBI scans were performed. Whole-body MIBI scanning correctly detected 68 (92%) of 74 metastatic lesions in the following sites: regional lymph nodes (n=23), non-regional lymph nodes (n=10), skin (n=16), brain/cerebellum (n=6), lung (n=8), bone (n=4) and breast (n=1). The technique failed to detect three subcutaneous regressive lesions (< 1 cm), one liver metastasis, one spleen metastasis and a case of multiple small lesions of the duodenal mucous membrane. In 14 patients the procedure detected previously unknown metastatic lesions. These results suggest that 99mTc-MIBI scanning is an effective imaging modality for whole-body screening of metastatic disease in malignant melanoma patients with the potential to influence treatment planning.
Nuclear Medicine Centre, Clinical Hospital of the University of Uruguay, Montevideo. oalonso@hc.edu.uy
O
O
Alonso
M
M
Martinez
F
F
Mut
L
L
Delgado
G
G
Lago
D
D
De Boni
C
C
Bazzano
M
M
Núñez
M
M
Garcés
I M
IM
Muse
R
R
Roca
E
E
Touya
J
J
Espasandín
J
J
Priario
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001859:Bone Neoplasms / Q000000981:diagnostic imaging / Q000556:secondary; D001932:Brain Neoplasms / Q000000981:diagnostic imaging / Q000556:secondary; D001943:Breast Neoplasms / Q000000981:diagnostic imaging / Q000556:secondary; D004067:Digestive System Neoplasms / Q000000981:diagnostic imaging / Q000556:secondary; D005069:Evaluation Studies as Topic; D005260:Female; D006801:Humans; D008175:Lung Neoplasms / Q000000981:diagnostic imaging / Q000556:secondary; D008207:Lymphatic Metastasis / Q000000981:diagnostic imaging*; D008297:Male; D008545:Melanoma / Q000000981:diagnostic imaging* / Q000556:secondary* / Q000601:surgery; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000000981:diagnostic imaging*; D009367:Neoplasm Staging / Q000379:methods; D018365:Neoplasm, Residual; D016719:Radioimmunodetection; D012680:Sensitivity and Specificity; D012878:Skin Neoplasms / Q000000981:diagnostic imaging*; D017256:Technetium Tc 99m Sestamibi
D017256:Technetium Tc 99m Sestamibi