Diagnostic value of 123I-IMT SPECT in the follow-up of head and neck cancer.
BACKGROUND
Nuclear medicine imaging is increasingly used in the evaluation of tumors of the head and neck. In the current study, we assess the value of single-photon emission tomography (SPECT) using the amino acid tracer L-3-[123I]iodine-alpha-methyl-tyrosine (IMT) for the detection of recurrent head and neck cancer.


METHODS
45 consecutive patients with suspected recurrence of previously treated head and neck cancer were examined by IMT-SPECT using a dual head system with integrated low-dose computed tomography (CT). The accuracy of the IMT-SPECT was evaluated by correlating the findings with results of histology or clinical and CT/MRI (magnetic resonance imaging) follow-up examinations.


RESULTS
The sensitivity, specificity and accuracy of IMT-SPECT in the detection of recurrent/persistent tumors were 83, 89 and 84.5%, respectively. The positive and negative predictive value amounted to 96.5 and 60%, respectively.


CONCLUSIONS
IMT-SPECT using integrated low-dose CT appears to be a helpful complementary imaging tool for the detection of local recurrences and lymph node metastases of head and neck cancer and their differentiation from treatment-induced changes. The advantage of the method is the high positive predictive value in the diagnosis of relapsed tumors. However, a negative IMT-SPECT result does not exclude a recurrence.
Plotkin
Michail
M
Department of Radiology, Nuclear Medicine and Radiooncology, Campus Virchow, Berlin, Germany. michail.plotkin@charite.de
Wurm
Reinhard
R
Kuczer
David
D
Wust
Peter
P
Michel
Roger
R
Denecke
Timm
T
Ruf
Juri
J
Schlenger
Lorenz
L
Bischoff
Annet
A
Felix
Roland
R
Amthauer
Holger
H
D005260:Female; D005500:Follow-Up Studies; D006258:Head and Neck Neoplasms / Q000000981:diagnostic imaging* / Q000628:therapy*; D006801:Humans; D008297:Male; D008781:Methyltyrosines; D009364:Neoplasm Recurrence, Local / Q000000981:diagnostic imaging* / Q000517:prevention & control*; D011379:Prognosis; D019275:Radiopharmaceuticals; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D015899:Tomography, Emission-Computed, Single-Photon / Q000379:methods*; D016896:Treatment Outcome
D008781:Methyltyrosines; D019275:Radiopharmaceuticals; C030855:3-iodo-alpha-methyltyrosine