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Comparative Study of Technetium-99m-Sestamibi and Thallium-201 SPECT in Predicting Chemotherapeutic Response in Small Cell Lung Cancer

Department of Radiology and First Department of Internal Medicine, Kagawa Medical University, Kagawa
Departments of Radiology and Internal Medicine, Takinomiya General Hospital, Kagawa, Japan

Correspondence: For correspondence or reprints contact: Yuka Yamamoto, MD. Department of Radiology, Kagawa Medical University, 1750-1 Ikenobe, Miki-cho, Kita-gun, Kagawa 761-07, Japan.

ABSTRACT

The purpose of this study was to evaluate the relationship between ^99mTc-sestamibi (MIBI) accumulation by tumor and response to chemotherapy in small cell lung cancer patients compared with ²⁰¹Tl-chloride. Methods: There were 19 patientS with small cell lung cancer just before chemotherapy initiation. The patients were classified by a follow-up CT into complete remission, partial remission and no change groups. All patients underwent dual-isotope imaging with ²⁰¹Tl-chloride and ^99mTc-MIBI. Regions of interest were placed over the tumors and contralateral normal lung tissue on one coronal view with a clearly defined lesion, and the tumor-to-normal (T/N) ratio and retention index were calculated. Results: Early and delayed T/N ratios for ^99mTc-MIBI in complete remission and partial remission groups were significantly higher (p < 0.05) than in the no change group. There was no significant correlation between T/N ratio and tumor response using ²⁰¹Tl-chloride. There were no significant differences in the retention index with respect to the tumor response in both ²⁰¹Tl-chloride and ^99mTc-MIBI SPECT images. Conclusion: Technetium-99m-MIBI SPECT may be more effective than ²⁰¹Tl-chloride SPECT for evaluating response to chemotherapy in patients with small cell lung cancer.

Key Words: technetium-99m-sestamibi • thallium-201-chloride • small cell lung cancer • dual-isotope imaging • chemotherapy

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