title: Image fusion of thallium-201 SPECT and MR imaging for the assessment of recurrent head and neck tumors following flap reconstructive surgery.
abstract: The aim of this study was to assess the value of fused MR and Tl-201 single photon emission computed tomography (SPECT) images in the diagnosis of recurrent head and neck tumors in patients after flap reconstruction surgery. Twenty-four patients after resection of primary head and neck tumors with flap reconstruction were suspected of having recurrent tumor by follow-up MR examination. Both MR examination and Tl-201 SPECT were prospectively performed to produce fused images. For qualitative analysis, two independent readers separately evaluated the existence of tumor recurrence in the fused images. The Tl-201 uptake of the lesion (Tl index) was also quantitatively compared with that of the normal nuchal muscles. Eighteen patients were histologically proved as having recurrence. The remaining 6 patients, false positive on MRI alone, had non-recurrence. Using the fused images, false positive was found in 1 case for one reader and 2 cases for the other reader. The Tl index of recurrent tumors was significantly higher (p < 0.001) than that of non-recurrent mass lesions. In the assessment of recurrent tumors following flap reconstruction surgery in the head and neck, the use of fused MRI and Tl-201 SPECT images can reduce the number of false positives.
authors.affiliation: Department of Radiology, Akita University School of Medicine, 1-1-1 Hondo, Akita City, 010-8543 Akita, Japan. tomura@med.akita-u.ac.jp
authors.forename: Noriaki
authors.initials: N
authors.lastname: Tomura
authors.forename: Osamu
authors.initials: O
authors.lastname: Watanabe
authors.forename: Koichi
authors.initials: K
authors.lastname: Omachi
authors.forename: Ikuo
authors.initials: I
authors.lastname: Sakuma
authors.forename: Satoshi
authors.initials: S
authors.lastname: Takahashi
authors.forename: Takahiro
authors.initials: T
authors.lastname: Otani
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Kidani
authors.forename: Jiro
authors.initials: J
authors.lastname: Watarai
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005189:False Positive Reactions; D005260:Female; D006801:Humans; D007091:Image Processing, Computer-Assisted; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009062:Mouth Neoplasms / Q000175:diagnosis* / Q000601:surgery; D009364:Neoplasm Recurrence, Local / Q000175:diagnosis*; D010039:Otorhinolaryngologic Neoplasms / Q000175:diagnosis* / Q000601:surgery; D019651:Plastic Surgery Procedures; D013524:Surgical Flaps; D013794:Thallium Radioisotopes; D015899:Tomography, Emission-Computed, Single-Photon
chemical_list: D013794:Thallium Radioisotopes