Superimposed dual-isotope SPECT using 99mTc-hydroxymethylene diphosphonate and 201Tl-chloride to assess cartilage invasion in laryngohypopharyngeal cancer.
OBJECTIVE
Cartilage invasion in laryngohypopharyngeal cancer has a significant impact on the choice of treatment modality and outcome of the disease. We examined invasion of cartilage in laryngohypopharyngeal cancer by simultaneous bone and tumor dual-isotope SPECT using 99mTc-hydroxymethylene diphosphonate and 201Tl-chloride.


METHODS
Early and delayed simultaneous bone and tumor dual-isotope SPECT were performed on 19 patients with laryngohypopharyngeal cancer. Dual-isotope SPECT images were superimposed to project tumor location from tumor SPECT onto the osseous structures shown by bone SPECT. The presence or absence of cartilage invasion was evaluated histopathologically or by radiological studies such as CT and/or MRI.


RESULTS
Histopathological or radiological examination of the cartilage revealed invasion in 5 patients and no invasion in 14 patients. The results of both early and delayed dual-isotope SPECT were exactly the same. Using dual-isotope SPECT, the sensitivity, specificity, and accuracy in detecting cartilage invasion by laryngohypopharyngeal cancer were: 80% (4/5), 92.9% (13/14), and 89.5% (17/19), respectively.


CONCLUSIONS
Results of the present study suggest that superimposed early bone and tumor dual-isotope SPECT images may be sufficient for the diagnostic evaluation of cartilage invasion by laryngohypopharyngeal cancer. Superimposed dual-isotope SPECT imaging is a useful technique in the evaluation of cartilage invasion in laryngohypopharyngeal cancer.
Nishiyama
Yoshihiro
Y
Departments of Radiology, Faculty of Medicine, Kagawa University, Kita-gun, Japan. nisiyosi@kms.ac.jp
Yamamoto
Yuka
Y
Yokoe
Koiku
K
Miyabe
Kazunori
K
Iwasaki
Takanobu
T
Toyama
Yoshihiro
Y
Satoh
Katashi
K
Ohkawa
Motoomi
M
D000368:Aged; D002356:Cartilage / Q000000981:diagnostic imaging*; D005260:Female; D006801:Humans; D007089:Image Enhancement / Q000379:methods; D007817:Laryngeal Cartilages / Q000000981:diagnostic imaging; D007822:Laryngeal Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology; D008297:Male; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D010610:Pharyngeal Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology; D019275:Radiopharmaceuticals; D015203:Reproducibility of Results; D018570:Risk Assessment / Q000379:methods*; D012307:Risk Factors; D012680:Sensitivity and Specificity; D013382:Subtraction Technique; D013669:Technetium Tc 99m Medronate / Q000031:analogs & derivatives*; D013793:Thallium; D015899:Tomography, Emission-Computed, Single-Photon / Q000379:methods*
D019275:Radiopharmaceuticals; C027549:thallium chloride; C024226:technetium Tc 99m hydroxymethylene diphosphonate; D013793:Thallium; D013669:Technetium Tc 99m Medronate