title: Efficacy of 99mTc-EDDA/HYNIC-TOC scintigraphy in differential diagnosis of solitary pulmonary nodules.
abstract: Fifty consecutive patients with solitary pulmonary nodules (SPN) on chest radiographs were studied scintigraphically after the administration of a somatostatin analog 99mTc-EDDA/HYNIC-TOC. The activity amounted to 740-925 MBq and a single photon emission computed tomography (SPECT) technique was applied. Verification of the nodule etiology was based on histology or cytology and bacteriology. As additional criterion for nodule benignity, its stable size in a chest radiograph for at least 3 years was accepted. In 31 patients, malignant etiologies of nodules were found. The diagnoses included: 11 adenocarcinomas, 6 squamous-cell carcinomas, 2 large-cell carcinomas, 6 nonsmall-cell lung cancers (NSCLC) of unspecified, more detailed morphology, 2 small-cell lung cancers (SCLC), 2 typical carcinoids, and 2 metastatic tumors: leiomyosarcoma and malignant melanoma. In 19 patients, the following benign tumors were diagnosed: 6 tuberculomas, 2 other granulomas, 4 hamartomas, 2 nonspecific inflammatory infiltrates, 1 abscess, 1 peripheral carcinoid of morphological characteristics of a benign tumor, 1 ectopic lesion of thyroid tissue, and 2 benign tumors of unspecified etiology, with stable size over 3 and 5 years. Positive scintigraphic results were obtained in 28 of 31 patients (90%) with malignant SPNs; among these there were 26 of 27 (96%) cases of primary pulmonary carcinoma. The remaining 2 false-negative cases included metastatic tumors: liposarcoma and melanoma. Among 19 benign lesions, 15 (79%) did not accumulate the radiopharmaceutical. The remaining 4 tumors visible on scintigrams included: 1 tuberculoma, 1 hamartoma, 1 abscess, and 1 case of nonestablished diagnosis (with stable size over 3 years). In conclusion, scintigraphy with 99mTc-EDDA/HYNIC-TOC appears to be an effective procedure for differentiation between malignant and benign SPNs.
authors.affiliation: Department of Nuclear Medicine, Medical University, Łódź, Poland. anna@csk.am.lodz.pl
authors.forename: Anna
authors.initials: A
authors.lastname: Płachcińska
authors.forename: Renata
authors.initials: R
authors.lastname: Mikołajczak
authors.forename: Helmut
authors.initials: H
authors.lastname: Maecke
authors.forename: Józef
authors.initials: J
authors.lastname: Kozak
authors.forename: Andrzej
authors.initials: A
authors.lastname: Michalski
authors.forename: Katarzyna
authors.initials: K
authors.lastname: Rzeszutek
authors.forename: Jacek
authors.initials: J
authors.lastname: Kuśmierek
mesh_terms: D000230:Adenocarcinoma / Q000175:diagnosis; D000328:Adult; D000368:Aged; D002276:Carcinoid Tumor / Q000175:diagnosis; D018287:Carcinoma, Large Cell / Q000175:diagnosis; D002289:Carcinoma, Non-Small-Cell Lung / Q000175:diagnosis; D002294:Carcinoma, Squamous Cell / Q000175:diagnosis; D045744:Cell Line, Tumor; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D007091:Image Processing, Computer-Assisted; D007249:Inflammation; D008168:Lung / Q000473:pathology; D008175:Lung Neoplasms / Q000175:diagnosis*; D008297:Male; D008875:Middle Aged; D009362:Neoplasm Metastasis; D015609:Organotechnetium Compounds / Q000494:pharmacology*; D011877:Radionuclide Imaging / Q000379:methods; D019275:Radiopharmaceuticals / Q000494:pharmacology*; D003074:Solitary Pulmonary Nodule / Q000175:diagnosis*; D013004:Somatostatin / Q000031:analogs & derivatives; D013997:Time Factors; D015899:Tomography, Emission-Computed, Single-Photon / Q000379:methods*
chemical_list: D015609:Organotechnetium Compounds; D019275:Radiopharmaceuticals; C487389:technetium 99m EDDA-HYNIC-Tyr(3)-octreotide; D013004:Somatostatin