Evaluation of breath-hold 201Tl SPECT in the differential diagnosis of solitary pulmonary nodules.
The aim of this study was to evaluate the usefulness of deep inspiration breath-hold SPECT (BrST, a method for 201Tl SPECT) in the diagnosis of solitary pulmonary nodules (SPN).


METHODS
Ten patients with malignant lesions and five with benign lesions were enrolled in this study. Early SPECT acquisition was performed 15 min after injection of 201Tl, while delayed SPECT images were acquired 3 h after injection. The first 15-sec acquisition was done using the BrST technique, and the second with the conventional free breathing (FB) method. We performed this technique alternately, and therefore, the odd data were from BrST and the even data were from FB. We referred to the T/N ratio of the early images as the ER and to the T/N ratio of the delayed images as the DR. To semi-quantitatively evaluate the degree of retention in the lesion, the retention index (RI) was calculated.


RESULTS
The RI of BrST indicated greater accuracy than that of FB in the differential diagnosis of SPN. For the benign and malignant lesions, the RI of BrST was -3.07 +/- 31.51 and 29.86 +/- 25.01, respectively (p < 0.05). The sensitivity, specificity, and accuracy of BrST (80%, 80%, and 80%, respectively) were significantly higher than those of FB (p < 0.05).


CONCLUSIONS
The BrST method is more accurate than that of the conventional FB method in the differential diagnosis of SPN.
Komori
Tsuyoshi
T
Department of Radiology, Osaka Medical College, 2-7 Daigaku-machi, Takatsuki, Osaka 569-8686, Japan. rad031@poh.osaka-med.ac.jp
Narabayashi
Isamu
I
Hayashi
Masuo
M
Horiuchi
Shoji
S
Adachi
Itaru
I
Ogura
Yasuharu
Y
Ohta
Hitoya
H
Utsunomiya
Keita
K
D000368:Aged; D000369:Aged, 80 and over; D016477:Artifacts; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D007089:Image Enhancement / Q000379:methods*; D008175:Lung Neoplasms / Q000000981:diagnostic imaging; D008297:Male; D008875:Middle Aged; D009068:Movement; D019275:Radiopharmaceuticals; D015203:Reproducibility of Results; D012119:Respiration; D012680:Sensitivity and Specificity; D003074:Solitary Pulmonary Nodule / Q000000981:diagnostic imaging*; D013793:Thallium; D015899:Tomography, Emission-Computed, Single-Photon / Q000379:methods*
D019275:Radiopharmaceuticals; C027549:thallium chloride; D013793:Thallium