title: Diagnostic Value of Semiquantitative Analysis of 99mTechnetium-Methoxyisobutylisonitrile (99mTc-MIBI) Imaging in Predicting Early-Stage Cervical Lymph Node Metastasis of Thyroid Carcinoma.
abstract: BACKGROUND The aim of this study was to evaluate the value of semiquantitative analysis (SQA) of 99mTc-MIBI imaging in predicting early-stage cervical lymph node metastasis (CLNM) in thyroid carcinoma (TC). MATERIAL AND METHODS TC patients (n =106) undergoing surgical resection and histopathological examination were enrolled. All patients received 99mTc-MIBI imaging prior to surgery. P-glycoprotein (P-gp) expression was detected by PT-PCR and immunohistochemistry. With pathological results as the criterion standard, the diagnostic efficiency of 99mTc-MIBI imaging in predicting early-stage CLNM was evaluated. The correlation of P-gp with 99mTc-MIBI imaging was investigated. Logistic regression analysis was applied for analyzing the factors affecting early-stage CLNM. RESULTS The detection rate and misdiagnosis rate of 99mTc-MIBI imaging for early-stage CLNM diagnosis were 87.3% and 12.7%, respectively. Receiver operating characteristic (ROC) curve analysis showed an accuracy of 99mTc-MIBI imaging of 85.85%. Preoperative 99mTc-MIBI scan showed statistical differences between metastasis and non-metastasis groups in early and delayed T/NT and washout rate (all P<0.05). The percentage of P-gp-expressing cells and the expression rate of P-gp gene both exhibited statistical differences between metastasis and no-metastasis groups (both P<0.05). Tumor diameter, lesion distribution, the percentage of P-gp-expressing cells, and the expression rate of P-gp gene were risk factors for CLNM (all P<0.05). CONCLUSIONS 99mTc-MIBI imaging has value in qualitative diagnosis of early-stage CLNM in TC. Tumor diameter, lesion distribution, the percentage of P-gp-expressing cells, and the expression rate of P-gp gene were risk factors for CLNM.
authors.affiliation: Department of Nuclear Medicine, Shanghai 9th People's Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China (mainland).
authors.forename: Xiao-Chun
authors.initials: XC
authors.lastname: Zhu
authors.affiliation: Department of Laboratory, Shanghai 9th People's Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China (mainland).
authors.forename: Kai
authors.initials: K
authors.lastname: Zhou
authors.affiliation: Department of Nuclear Medicine, Shanghai 9th People's Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China (mainland).
authors.forename: Shi-Qing
authors.initials: SQ
authors.lastname: Xu
authors.affiliation: Department of Nuclear Medicine, Shanghai 9th People's Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China (mainland).
authors.forename: Yu-Bo
authors.initials: YB
authors.lastname: Ma
mesh_terms: D020168:ATP Binding Cassette Transporter, Subfamily B, Member 1 / Q000378:metabolism; D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D008198:Lymph Nodes / Q000000981:diagnostic imaging* / Q000473:pathology; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D011379:Prognosis; D011877:Radionuclide Imaging; D019275:Radiopharmaceuticals; D017256:Technetium Tc 99m Sestamibi; D013964:Thyroid Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology
chemical_list: D020168:ATP Binding Cassette Transporter, Subfamily B, Member 1; D019275:Radiopharmaceuticals; D017256:Technetium Tc 99m Sestamibi