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Increased Thallium-201 Uptake in Collapsed Lung: A Pitfall in Scintigraphic Evaluation of Central Bronchogenic Carcinoma

Department of Diagnostic Radiology, Pulmonology, Chest Surgery and Pathology, Yonsei University College of Medicine, Seoul, Korea

Correspondence: For correspondence or reprint requests contact: Jong Doo Lee, MD, Dept. of Diagnostic Radiology, Yonsei University, College of Medicine, 134 Shinchon-dong, Seodaemun-gu, Seoul, 120-752, Korea.

ABSTRACT

This study evaluated whether ²⁰¹Tl scintigraphy can differentiate a central bronchogenic cancer from a distal collapse consolidation. Methods: Nine patients with squamous carcinoma with collapse confirmed by surgery and pathology were included. All patients underwent SPECT 1 hr after an intravenous injection of 3 mCi of ²⁰¹Tl. Four-hour delayed SPECT was performed in five of the nine patients. The thallium activity in tumor and collapse was visually assessed on the basis of the pathologic findings. The specimens were prepared to have the same orientation and level with the SPECT image. Results: The tumor activity appeared higher than that of the collapse in four patients, equal in three patients and lower in two patients. Both collapsed lung with and without superimposed inflammation also showed increased thallium activity. Delayed SPECT aided in tumor detection within a collapsed lung in only two of the five patients. Conclusion: Our study illustrates the need for caution in the interpretation of thallium scintigraphy in patients with central bronchogenic cancer and distal collapse.

Key Words: lung cancer • thallium-201 • SPECT

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