Tc-99m MIBI liver imaging for hepatocellular carcinoma: correlation with P-glycoprotein-multidrug-resistance gene expression.
OBJECTIVE
Technetium-99m methoxyisobutyl isonitrile (MIBI) has been shown to be useful in identifying several types of tumors, such as breast, lung and thyroid cancers. There are only a few reports in the literature regarding Tc-99m MIBI uptake in hepatocellular carcinoma, and the results are conflicting. The aim of this study was to investigate the relationship between Tc-99m MIBI accumulation in patients with hepatocellular carcinoma and the gene expression of P-glycoprotein-multidrug-resistance.


METHODS
Twenty-two patients with hepatocellular carcinoma were enrolled in this study. Tc-99m MIBI imaging was performed 10 minutes after intravenous injection of 20 mCi Tc-99m MIBI. All patients had liver biopsy or surgery within 1 week of MIBI imaging. Immunohistochemical study of the biopsy or resected hepatocellular carcinoma specimens was performed using the anti-human P-glycoprotein antibody.


RESULTS
On Tc-99m MIBI imaging, 20 of 22 (90.9%) patients with hepatocellular carcinoma showed negative Tc-99m MIBI uptake in tumor lesions, whereas only 2 patients showed positive Tc-99m MIBI uptake in tumor lesions. P-glycoprotein expression was observed in 13 of 20 (65%) patients with negative Tc-99m MIBI uptake, but in the 2 patients who showed positive Tc-99m MIBI uptake in tumor lesions, P-glycoprotein expression was negative.


CONCLUSIONS
Tc-99m MIBI SPECT is a useful noninvasive method for predicting the expression of P-glycoprotein-multidrug-resistance gene in hepatocellular carcinoma patients.
Chang
Chi-Sen
CS
Division of Gastroenterology, Taichung Veterans General Hospital, Taichung, Taiwan, ROC. changcs@vghtc.vghtc.gov.tw
Yang
Sheng-Shun
SS
Yeh
Hong-Zen
HZ
Kao
Chia-Hung
CH
Chen
Gran-Hum
GH
D020168:ATP Binding Cassette Transporter, Subfamily B, Member 1 / Q000378:metabolism*; D000328:Adult; D000368:Aged; D006528:Carcinoma, Hepatocellular / Q000000981:diagnostic imaging*; D019008:Drug Resistance, Neoplasm / Q000502:physiology*; D005260:Female; D019450:Genes, MDR / Q000502:physiology*; D006801:Humans; D008113:Liver Neoplasms / Q000000981:diagnostic imaging*; D008297:Male; D008875:Middle Aged; D011877:Radionuclide Imaging; D019275:Radiopharmaceuticals; D017256:Technetium Tc 99m Sestamibi
D020168:ATP Binding Cassette Transporter, Subfamily B, Member 1; D019275:Radiopharmaceuticals; D017256:Technetium Tc 99m Sestamibi