title: Evaluation of undifferentiated carcinoma of nasopharyngeal type with thallium-201 and technetium-99m MIBI SPECT.
abstract: OBJECTIVE
  To determine the value of 201-thallium (201-Tl) and technetium-99m sestamibi (Tc-99m MIBI) single photon emission computed tomography (SPECT) for detecting primary undifferentiated carcinoma of nasopharyngeal type (UCNT), residual/recurrent tissue, and lymph node involvement.
  
  
  METHODS
  SPECT of head and neck was prospectively performed in 46 patients with a history of UCNT (201-Tl in 24 patients, Tc-99m MIBI in 22). CT/MRI findings, clinical follow-up, and pathohistological verification served as a gold standard for calculating sensitivity, specificity, and accuracy of each scintigraphic technique. Tumor-to-background index (T/Bg) was derived when SPECT findings were positive.
  
  
  RESULTS
  Sensitivity of 201-Tl SPECT was 87 percent, with 78 percent specificity, 83 percent accuracy, and T/Bg of 4.05 +/- 1.50. Tc-99m MIBI SPECT had 85 percent sensitivity, 78 percent specificity, 82 percent accuracy, and T/Bg of 4.45 +/- 1.27.
  
  
  CONCLUSIONS
  201-Tl SPECT and Tc-99m MIBI SPECT are useful for detecting primary UCNT, residual/recurrent disease, and lymph node involvement. This use is particularly valuable after chemoradiotherapy when CT/MRI may be ambiguous.
authors.affiliation: Institute of Nuclear Medicine, Clinical Center of Serbia, Belgrade, Serbia. dsobic@EUnet.yu
authors.forename: Dragana P
authors.initials: DP
authors.lastname: Sobic-Saranovic
authors.forename: Ivica P
authors.initials: IP
authors.lastname: Pendjer
authors.forename: Nebojsa Dj
authors.initials: NDj
authors.lastname: Kozarevic
authors.forename: Vera M
authors.initials: VM
authors.lastname: Artiko
authors.forename: Anton A
authors.initials: AA
authors.lastname: Mikic
authors.forename: Vladimir B
authors.initials: VB
authors.lastname: Obradovic
mesh_terms: D000328:Adult; D002277:Carcinoma / Q000000981:diagnostic imaging* / Q000473:pathology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009303:Nasopharyngeal Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology; D009364:Neoplasm Recurrence, Local / Q000175:diagnosis; D018365:Neoplasm, Residual; D011237:Predictive Value of Tests; D011446:Prospective Studies; D019275:Radiopharmaceuticals; D017256:Technetium Tc 99m Sestamibi; D013794:Thallium Radioisotopes; D015899:Tomography, Emission-Computed, Single-Photon
chemical_list: D019275:Radiopharmaceuticals; D013794:Thallium Radioisotopes; D017256:Technetium Tc 99m Sestamibi