Combined SPECT/CT imaging using 123I-IMT in the detection of recurrent or persistent head and neck cancer.
The aim of the study was to assess the clinical value of combined SPECT/CT imaging using L: -3-[123I]iodine-alpha-methyl tyrosine (IMT) for the differential diagnosis of recurrences in patients pre-treated for head and neck cancer. Thirty-four consecutive patients with biopsy-proven carcinomas, who had previously been treated by surgery and/or radio/chemotherapy, were examined at our clinic by IMT-SPECT using a dual-head system with integrated low-dose CT. SPECT results were correlated with histopathology, clinical and CT/MRI follow-up data. In the follow-up after SPECT examination, the final diagnosis of recurrent tumour was established in 26 patients; the remaining eight patients were recurrence-free (follow-up >6 months). IMT-SPECT/CT correctly detected recurrent disease and/or neck lymph node metastases in 22 patients. In addition, distant metastases were displayed in two patients. The study was false-negative in four patients (sensitivity 85%). True-negative results were registered in seven patients, and false-positive in one patient. Image fusion with coregistered low-dose CT facilitates the localisation and interpretation of IMT-SPECT findings. IMT-SPECT using integrated low-dose CT is a promising non-invasive imaging tool for the detection of head and neck cancer recurrences and their differentiation from treatment-induced changes.
Department of Radiology, Nuclear Medicine and Radiooncology, Campus Virchow, Berlin, Germany. michail.plotkin@charite.de
Michail
M
Plotkin
Reinhard
R
Wurm
Julia
J
Eisenacher
Katarzyna
K
Szerewicz
Roger
R
Michel
Lorenz
L
Schlenger
Maciej
M
Pech
Timm
T
Denecke
David
D
Kuczer
Annet
A
Bischoff
Roland
R
Felix
Holger
H
Amthauer
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003937:Diagnosis, Differential; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007089:Image Enhancement; D007091:Image Processing, Computer-Assisted; D007457:Iodine Radioisotopes; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000175:diagnosis* / Q000473:pathology; D009367:Neoplasm Staging; D010039:Otorhinolaryngologic Neoplasms / Q000175:diagnosis* / Q000473:pathology; D013223:Statistics as Topic; D015899:Tomography, Emission-Computed, Single-Photon; D014057:Tomography, X-Ray Computed; D019805:alpha-Methyltyrosine
D007457:Iodine Radioisotopes; D019805:alpha-Methyltyrosine