Evaluating benign and malignant musculoskeletal lesions with radionuclide angiography and SPECT using Tc-99m MIBI.
OBJECTIVE
The purpose of this study was to evaluate the use of radionuclide angiography and single photon emission computed tomography (SPECT) using Tc-99m hexakis-2-methoxyisobutylisonitrile (Tc-99m MIBI) for analyzing musculoskeletal lesions.


METHODS
Radionuclide angiography and SPECT using Tc-99m MIBI were performed in 36 patients with various soft tissue and bone pathologies (18 benign and 18 malignant lesions). The ratio of the counts of the lesion to that of the contralateral normal area was calculated from the region of interest drawn on the MIBI scan. The MIBI-uptake ratio was calculated using SPECT and the MIBI-perfusion index was calculated using radionuclide angiography.


RESULTS
The MIBI-uptake ratio in malignant lesions (4.80 +/- 4.43) was significantly higher (P < 0.05) than that in benign lesions (1.83+/-2.48). The sensitivity, specificity, accuracy, positive predictive value, and negative predictive value of the MIBI-uptake ratio for malignant lesions were 72%, 83%, 78%, 81%, and 75%, respectively. The MIBI-perfusion index in malignant lesions (17.68 +/- 21.19) was significantly higher (P < 0.05) than that in benign lesions (2.25 +/- 2.56). The sensitivity, specificity, accuracy, positive predictive value, and negative predictive value of the MIBI-perfusion index for malignant lesions were 87%, 75%, 81%, 77%, and 86%, respectively.


CONCLUSIONS
The MIBI-uptake ratio and MIBI-perfusion index using Tc-99m MIBI can yield important additional information with which to differentiate musculoskeletal lesions.
Ishiyama
Koichi
K
Department of Radiology, Akita University School of Medicine, Akita, Japan. kishiyam@doc.med.akita-u.ac.jp
Tomura
Noriaki
N
Okada
Kyoji
K
Nagasawa
Hiroyuki
H
Sashi
Ryuji
R
Sasaki
Kazufumi
K
Sato
Kimihiko
K
Watarai
Jiro
J
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001859:Bone Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D019042:Muscle Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology; D011875:Radionuclide Angiography / Q000379:methods*; D019275:Radiopharmaceuticals; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D017256:Technetium Tc 99m Sestamibi; D015899:Tomography, Emission-Computed, Single-Photon / Q000379:methods*
D019275:Radiopharmaceuticals; D017256:Technetium Tc 99m Sestamibi