99mTc-depreotide scintigraphy in the evaluation of indeterminate pulmonary lesions: clinical experience.
Indeterminate lung nodules (LN) constitute a clinical problem of increasing frequency that requires an effective diagnostic approach. This study evaluates the contribution of 99mTc-depreotide scintigraphy in the management of such patients. Forty (40) patients (27 males/13 females) 29 to 82 years old (61 +/- 12) with lung nodules/masses of indeterminate origin on computed tomography (CT) images were injected with 99mTc-depreotide and underwent thoracic tomography (single photon emission computed tomography) 2 and 4-4.5 hours later. All parenchymal lesions (50) identified by CT were scored as negative or positive as to the uptake of 99mTc-depreotide. Positive images were also evaluated semiquantitatively. Thirty (30) of 31 malignant lesions were positive (97% sensitivity) and 12 out of 19 benign lesions were negative (63% specificity), with positive images obtained in benign processes such as inflammation/infection and bronchiectasis. Semiquantitative analysis showed a statistically significant difference between benign and malignant positive lesions on the late images, and may play a complementary role in interpretation. 99mTc-depreotide was a useful noninvasive tool in the evaluation of patients with LN, allowing for the exclusion of malignancy with great confidence, due to its high sensitivity. Because of moderate specificity, a positive test is best valued together with clinical and radiological features.
Martins
Teresa
T
Department of Nuclear Medicine, Hospital de Santa Cruz, Carnaxide, Portugal. tmartins@hsc.min-saude.pt
Lino
José Sena
JS
Ramos
Sância
S
Oliveira
Luis
L
D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D008171:Lung Diseases / Q000000981:diagnostic imaging* / Q000473:pathology; D008175:Lung Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology; D008297:Male; D008875:Middle Aged; D015609:Organotechnetium Compounds; D019275:Radiopharmaceuticals; D012680:Sensitivity and Specificity; D013004:Somatostatin / Q000031:analogs & derivatives*; D015899:Tomography, Emission-Computed, Single-Photon
D015609:Organotechnetium Compounds; D019275:Radiopharmaceuticals; D013004:Somatostatin; C444119:technetium Tc 99m depreotide