title: Correlation of 99mTc-sestamibi uptake with blood-pool and osseous phase 99mTc-MDP uptake in malignant bone and soft-tissue tumours.
abstract: Technetium-99m-sestamibi (99mTc-MIBI) imaging is a well-established modality in oncologic investigations. The current study aimed to investigate whether any relationship could be found between 99mTc-MIBI uptake and local perfusion in malignant bone and soft-tissue tumours. It also aimed to compare 99mTc-MIBI images with those of technetium-99m-methylene diphosphonate (99mTc-MDP) bone scintigraphy with regard to the activity distribution pattern, intensity and lesion extension. The study group included 24 patients with various bone and soft-tissue tumours. Three-phase bone scintigraphy and 99mTc-MIBI studies were performed within the same week before any surgical and therapeutic intervention. Images were evaluated visually and quantitatively using regions of interest (ROIs) over the lesion and adjacent normal tissue. The 99mTc-MIBI study was positive with varying degrees of uptake (range, 1.4-5.3). The mean 99mTc-MIBI uptake and 99mTc-MDP blood-pool and osseous phase activity ratios were 2.5 +/- 0.5, 2.8 +/- 1.0 and 5.5 +/- 4.0, respectively. The correlation between the 99mTc-MIBI uptake and blood-pool ratios was 0.70 (P<0.05). While activity distribution patterns were in agreement in 99mTc-MIBI and blood-pool images in the majority of cases, 99mTc-MIBI better delineated tumour viability and extension in five cases. In conclusion, 99mTc-MIBI accumulation shows a reasonable correlation with blood-pool uptake assuming the presence of multifactorial mechanisms in addition to local hyperaemia. Better delineation of tumour outlines and cellular activity seems to be an advantage of 99mTc-MIBI scintigraphy which may be helpful in the evaluation of musculoskeletal tumours.
authors.affiliation: Ege University Medical Faculty, Department of Nuclear Medicine, Izmir, Turkey. zehraozcan@ixir.com
authors.forename: Z
authors.initials: Z
authors.lastname: Ozcan
authors.forename: Z
authors.initials: Z
authors.lastname: Burak
authors.forename: R
authors.initials: R
authors.lastname: Erinç
authors.forename: A
authors.initials: A
authors.lastname: Dirlik
authors.forename: G
authors.initials: G
authors.lastname: Başdemir
authors.forename: D
authors.initials: D
authors.lastname: Sabah
authors.forename: H
authors.initials: H
authors.lastname: Ozkiliç
mesh_terms: D000293:Adolescent; D000328:Adult; D001859:Bone Neoplasms / Q000098:blood supply / Q000000981:diagnostic imaging* / Q000378:metabolism*; D002648:Child; D005260:Female; D006801:Humans; D007091:Image Processing, Computer-Assisted; D008297:Male; D008875:Middle Aged; D012516:Osteosarcoma / Q000000981:diagnostic imaging; D011877:Radionuclide Imaging; D019275:Radiopharmaceuticals / Q000097:blood / Q000493:pharmacokinetics*; D012039:Regional Blood Flow / Q000502:physiology; D012509:Sarcoma / Q000098:blood supply / Q000000981:diagnostic imaging* / Q000378:metabolism*; D012983:Soft Tissue Neoplasms / Q000098:blood supply / Q000378:metabolism*; D013669:Technetium Tc 99m Medronate / Q000097:blood / Q000493:pharmacokinetics*; D017256:Technetium Tc 99m Sestamibi / Q000097:blood / Q000493:pharmacokinetics*
chemical_list: D019275:Radiopharmaceuticals; D017256:Technetium Tc 99m Sestamibi; D013669:Technetium Tc 99m Medronate