title: The role of 99mTc-tetrofosmin scintigraphy for staging patients with laryngeal cancer.
abstract: Diagnosis and staging of laryngeal cancer is currently based on physical examination, endoscopy, and imaging techniques such as computed tomography (CT) and/or magnetic resonance (MR) and histology. While imaging techniques have a pivotal role for defining the size of the primary tumor, they are less accurate for defining metastatic involvement of regional lymph nodes, especially if lymph nodes are smaller than 10-15 mm. The aim of this study was to comparatively assess the relevance of (99m)Tc-tetrofosmin scintigraphy for the staging of laryngeal tumors versus the CT scan. We evaluated the sensitivity of imaging with (99m)Tc-tetrofosmin in 28 consecutively enrolled patients with squamous cell laryngeal carcinoma. Total-body scintigraphy with 99mTc-tetrofosmin was performed preoperatively, and the results were compared to CT images of the neck and mediastinum. CT and (99m)Tc-tetrofosmin scintigraphy were equally sensitive (96%) in identifying the primary tumor. While CT was more sensitive for detecting metastatic lymph nodes (100% versus 50%), (99m)Tc-tetrofosmin scintigraphy was more specific (100% versus 56%; p < 0.04). The overall diagnostic capabilities of the two techniques for detecting lymph node metastases were comparable (Youden Index: J = 0.56 for CT and J = 0.50 for (99m)Tc-tetrofosmin scintigraphy). (99m)Tc-tetrofosmin scintigraphy is a useful complement to CT for staging laryngeal tumors, especially for detecting metastatic lymph nodes and distant metastases.
authors.affiliation: Ear, Nose and Throat Unit, Department of Neurosciences, University of Pisa Medical School, Pisa, Italy.
authors.forename: Bruno
authors.initials: B
authors.lastname: Fattori
authors.forename: Mariano
authors.initials: M
authors.lastname: Grosso
authors.forename: Andrea
authors.initials: A
authors.lastname: Nacci
authors.forename: Francesca
authors.initials: F
authors.lastname: Bianchi
authors.forename: Mirco
authors.initials: M
authors.lastname: Cosottini
authors.forename: Francesco
authors.initials: F
authors.lastname: Ursino
authors.forename: Gianpiero
authors.initials: G
authors.lastname: Manca
authors.forename: Domenico
authors.initials: D
authors.lastname: Rubello
authors.forename: H William
authors.initials: HW
authors.lastname: Strauss
authors.forename: Giuliano
authors.initials: G
authors.lastname: Mariani
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D006801:Humans; D007091:Image Processing, Computer-Assisted; D007822:Laryngeal Neoplasms / Q000175:diagnosis* / Q000532:radiotherapy*; D008198:Lymph Nodes / Q000473:pathology; D008207:Lymphatic Metastasis; D008875:Middle Aged; D009362:Neoplasm Metastasis; D009367:Neoplasm Staging / Q000379:methods*; D009943:Organophosphorus Compounds / Q000494:pharmacology*; D015609:Organotechnetium Compounds / Q000494:pharmacology*; D011877:Radionuclide Imaging / Q000379:methods*; D019275:Radiopharmaceuticals / Q000494:pharmacology*; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D015899:Tomography, Emission-Computed, Single-Photon; D014057:Tomography, X-Ray Computed / Q000379:methods
chemical_list: D009943:Organophosphorus Compounds; D015609:Organotechnetium Compounds; D019275:Radiopharmaceuticals; C078700:technetium tc-99m tetrofosmin