Article Figures & Data
Figures
- FIGURE 1.
Anterior (left) and posterior (right) whole-body IMT scintigrams of healthy volunteer 30 min after injection show low-grade brain, liver, and spleen uptake and intense kidney and urinary system uptake.
- FIGURE 2.
Maximum-intensity projection from TYR PET study shows normal distribution in chest and upper abdomen; low uptake in bone marrow, liver, and stomach; and intense uptake in pancreas.
- FIGURE 3.
Planar IMT image obtained 1 wk after 60 Gy radiotherapy in patient with non–small cell lung carcinoma in right middle lobe shows nonspecific increased uptake in irradiated field (arrows).
- FIGURE 4.
Coronal, transverse, and sagittal images obtained using H215O (perfusion, left column), FDG (middle column), and TYR (right column) in patient with large, low-grade astrocytoma in left temporoparietal region show that tumor is not intensely perfused and glucose metabolism is low. However, large area of irregularly increased amino acid uptake is clearly seen, and amino acid uptake is noted in lacrimal gland.
- FIGURE 5.
IMT SPECT (top row) and MET PET (bottom row) images of brain of patient with glioma show similar uptake and tumor delineation. Resolution of MET PET was converted to SPECT resolution.
- FIGURE 6.
Coronal and sagittal projections of TYR PET study of patient with large, recurrent squamous cell carcinoma of right maxillary sinus extending into skull base show irregularly increased TYR uptake in tumor (thick arrows). Because of irradiation, uptake in both parotid glands and right submandibular gland has disappeared, and uptake in left submandibular gland is visible (thin arrows).
- FIGURE 7.
Coronal chest IMT SPECT section through 6-cm squamous cell carcinoma in right middle lobe of same patient as in Figure 3 shows high IMT uptake.
- FIGURE 8.
Transverse chest IMT SPECT image of patient with large cell carcinoma of left upper lobe and mediastinal metastasis shows avid uptake in both.
- FIGURE 9.
Coronal IMT SPECT sections through upper legs of patient with high-grade malignant fibrous histiocytoma, before (left) and after (right) regional hyperthermic cytostatic perfusion of leg, show disappearance of irregular intense IMT uptake after perfusion, in agreement with complete tumor necrosis.
Tables
Level Diagnostic test Seeks answers to whether the application … 1 Feasibility is feasible 2 Accuracy is sufficiently sensitive and specific 3 Diagnostic value performs well in relation to other tests 4 Therapeutic value results in better treatment 5 Patient and societal value results in better survival and quality of life, at acceptable cost Table is slightly adapted from (58).
Study Year No. of patients Purpose Sensitivity (%) Remarks and findings Biersack (59) 1989 10 Detection 100 First study Langen (36) 1990 32 Detection 88 Kuwert (55) 1995 53 Detection 50–82 Differentiation between high grade, low grade, and benign; specificity 83%–100% Weber (75) 1997 19 Detection 97 IMT uptake ratios superior to those of FDG PET Langen (115) 1997 14 Detection 100 Similar to MET PET Woesler (116) 1997 23 Detection 83 Differentiation between high and low grades; IMT similar to FDG PET Grosu (76) 2000 30 Detection 100 Significant impact on radiotherapy planning Guth (84) 1995 17 Evaluation 82 Recurrence detection Molenkamp (117) 1998 11 Evaluation 100 Detection of progression in low-grade childhood tumors Kuwert (118) 1998 27 Evaluation 78 Recurrence detection; specificity 100% Bader (69) 1999 30 Evaluation 75–100 Detection of recurrence, grades 2–4; superior to FDG PET Study Year No. of patients Tumor type Sensitivity (%) Remarks and findings Pruim (56) 1995 22 Primary brain 92 Specificity 67%; no correlation with grade Heesters (85) 1998 10 Primary brain — PSR within original tumor volume unchanged after radiotherapy Braams (89) 1996 11 Oral cavity 83 In nodal staging, better than MRI or CT; specificity 95% Kole (100) 1997 13 Breast cancer 100 For primary tumor; visually less uptake than for FDG in fibrocystic disease Ginkel (107) 1999 17 Sarcoma 82 Partial vs. complete remission distinguished after chemotherapy; specificity 100% Plaat (106) 1999 21 Sarcoma — Correlation of PSR with Ki-67, not with grade Kole (57) 1999 25 Sarcoma — FDG better for grading; TYR better for correlation with proliferation Kole (111) 1998 10 Nonseminoma 20 Kole (119) 1997 22 Various types 94 Chondrosarcoma not visualized Que (120) 2000 10 Cervix 80 Interfering bone marrow and intestinal uptake present PSR = protein synthesis rate.
Study Year No. of patients Tumor type Sensitivity (%) Remarks and findings Flamen (90) 1999 11 Head and neck 91 For primary tumors; ∼60% for nodal spread Jager (37) 1998 20 Various types — Feasible in breast cancer, lung cancer, sarcoma, and lymphoma Boni (109) 1997 7 Melanoma 37 For lesion detection Jager (110) 2000 22 Carcinoid 43–60 Correlation with secretory activity Jager (42) 2000 32 Sarcoma 100 88% specificity for differentiation between benign and malignant; correlation with proliferation Jager (96) 2000 17 Lung cancer 94 For primary tumors; 60% for mediastinal lesions
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