title: Detection of recurrent or persistent nasopharyngeal carcinomas after radiotherapy with technetium-99m methoxyisobutylisonitrile single photon emission computed tomography and computed tomography: comparison with 18-fluoro-2-deoxyglucose positron emission tomography.
abstract: BACKGROUND
  The diagnostic accuracy of technetium-99m methoxyisobutylisonitrile (Tc-MIBI) single photon emission computed tomography (SPECT) and computed tomography (CT) of the head and neck for differentiating recurrent or residual nasopharyngeal carcinomas (NPC) from benign lesions after radiotherapy was compared with positron emission tomography (PET) with 18-fluoro-2-deoxyglucose (FDG).
  
  
  METHODS
  Thirty six NPC patients underwent head and neck CT, Tc-MIBI SPECT, and FDG-PET four months after radiotherapy to differentiate recurrent or residual NPC from benign lesions. Histopathologic examinations of nasopharyngeal biopsies were performed for all 36 patients. No patients had multiple foci of NPC.
  
  
  RESULTS
  Based on biopsy results, the sensitivity, specificity, and accuracy of CT for differentiating recurrent or residual NPC from benign lesions were 73%, 88%, and 83%, respectively. The sensitivity, specificity, and accuracy of Tc-MIBI SPECT were 73%, 96%, and 89%, respectively. The sensitivity, specificity, and accuracy of FDG-PET were 100%, 96%, and 97%, respectively. Combination CT and Tc-MIBI SPECT for 28 NPC patients with congruent results showed the same sensitivity, specificity, and accuracy of 100%, 96%, and 96%, respectively, as FDG-PET for differentiating recurrent or residual NPC from benign lesions. In eight patients with incongruent results between CT and Tc-MIBI SPECT, FDG-PET correctly differentiated two benign lesions and six recurrent or residual NPCs.
  
  
  CONCLUSIONS
  In detecting recurrent or residual NPC, FDG-PET is the best tool. However, combined use of CT and Tc-MIBI SPECT can result in the same accuracy as FDG-PET.
authors.affiliation: Department of Nuclear Medicine, Positron Emission Tomography Center, China Medical College Hospital, No. 2 Yuh-Der Road, Taichung 404, Taiwan. d10040@hpd.cmch.org.tw
authors.forename: Chia-Hung
authors.initials: CH
authors.lastname: Kao
authors.forename: Yu-Chien
authors.initials: YC
authors.lastname: Shiau
authors.forename: Yeh-You
authors.initials: YY
authors.lastname: Shen
authors.forename: Ruoh-Fang
authors.initials: RF
authors.lastname: Yen
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D003937:Diagnosis, Differential; D005260:Female; D019788:Fluorodeoxyglucose F18; D006801:Humans; D008297:Male; D008875:Middle Aged; D009303:Nasopharyngeal Neoplasms / Q000000981:diagnostic imaging* / Q000532:radiotherapy; D009364:Neoplasm Recurrence, Local / Q000000981:diagnostic imaging*; D018365:Neoplasm, Residual; D019275:Radiopharmaceuticals; D015203:Reproducibility of Results; D017256:Technetium Tc 99m Sestamibi; D015899:Tomography, Emission-Computed, Single-Photon / Q000379:methods; D014057:Tomography, X-Ray Computed
chemical_list: D019275:Radiopharmaceuticals; D019788:Fluorodeoxyglucose F18; D017256:Technetium Tc 99m Sestamibi