The role of 99mTc-tetrofosmin scintigraphy for staging patients with laryngeal cancer.
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.
Fattori
Bruno
B
Ear, Nose and Throat Unit, Department of Neurosciences, University of Pisa Medical School, Pisa, Italy.
Grosso
Mariano
M
Nacci
Andrea
A
Bianchi
Francesca
F
Cosottini
Mirco
M
Ursino
Francesco
F
Manca
Gianpiero
G
Rubello
Domenico
D
Strauss
H William
HW
Mariani
Giuliano
G
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
D009943:Organophosphorus Compounds; D015609:Organotechnetium Compounds; D019275:Radiopharmaceuticals; C078700:technetium tc-99m tetrofosmin