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Thallium-201 SPECT and Technetium-99m-Phytate Subtraction Liver Imaging in the Evaluation of Pancreatic Cancers

Departments of Radiology and Second Surgery, Yamaguchi University School of Medicine, Kogushi, Japan

Correspondence: For correspondence or reprints contact: Kazuyoshi Suga, Department of Radiology, Yamaguchi University School of Medicine, Kogushi 1144, Ube, Japan 755.

ABSTRACT

We preliminary evaluated the usefulness of ²⁰¹Tl SPECT in the investigation of pancreatic cancers. Methods: The subjects included 32 patients with malignant tumors, 16 with benign disorders and 10 controls. SPECT was performed 10 min after the injection of 148–222 MBq of ²⁰¹Tl; subjects had fasted to minimize intestinal activity. In addition, subtracted SPECT using ^99mTc-phytate to separate the boundary of abnormal uptake from liver activity was carried out in 14 patients. Results: Thallium-201 did not accumulate in the pancreatic bed of the controls. In contrast, 29 of the 32 patients with malignant tumors showed positive phytate uptake with a sensitivity of 90.6% in the detection of malignancy. Of the 16 benign disorders, only four patients showed abnormal uptake; however, the mean value of the lesion-to-hepatic ratio (0.43 ± 0.06; range, 0.35–0.51), as an index of the degree of uptake, was lower than that in positive malignant tumors (0.72 ± 0.16; range, 0.53–1.28). Thallium-201 activity per milligram of resected cancer tissue in two patients was 2–3 times greater than in normal tissue. Follow-up ²⁰¹Tl SPECT in the five treated patients demonstrated similar alterations between ²⁰¹Tl uptake and tumor markers. Conclusion: Our results suggest that ²⁰¹Tl SPECT may have clinical potential in the investigation of pancreatic cancers.

Key Words: thallium-201-chloride • pancreatic cancer • chronic pancreatitis • single-photon emission computed tomography • technetium-99m-phytate