ABSTRACT
BACKGROUND/AIMS: The aim of our study was to evaluate technetium-99m tetrofosmin SPECT (single photon emission computed tomography) of the chest as a potential non-invasive method to evaluate esophagitis among gastroesophageal reflux disease patients. METHODOLOGY: In this study, we used non-invasive radionuclide imaging technetium-99m tetrofosmin chest SPECT to detect and grade esophagitis in 60 patients with gastroesophageal reflux disease. RESULTS: Based on the endoscopic findings according to the Savary-Miller system, the sensitivity, specificity, and accuracy rates of technetium-99m tetrofosmin chest SPECT in detecting esophagitis were 95.2%, 72.2%, and 88.3%, respectively. The agreement between the endoscopic and technetium-99m tetrofosmin chest SPECT findings was evaluated and found to be good (kappa: 0.633, p < 0.001). CONCLUSIONS: Non-invasive technetium-99m tetrofosmin chest SPECT has excellent sensitivity and good accuracy as a screen for esophagitis among gastroesophageal reflux disease patients.
Subject(s)
Esophagitis/diagnostic imaging , Esophagitis/etiology , Gastroesophageal Reflux/complications , Gastroesophageal Reflux/diagnostic imaging , Tomography, Emission-Computed, Single-Photon , Adult , Aged , Esophagoscopy , Female , Humans , Male , Middle Aged , Pilot Projects , Reproducibility of Results , Sensitivity and Specificity , Severity of Illness IndexABSTRACT
OBJECTIVE: The aim of this study was to compare technetium-99m methoxyisobutylisonitrile (Tc-MIBI) chest single photon emission computed tomography (SPECT) results, immunohistochemical analyses of P-glycoprotein (Pgp) expression and response to paclitaxel in non-small-cell lung cancer (NSCLC). METHODS: Before chemotherapy with paclitaxel, 30 patients with stage IIIb or IV NSCLC were enrolled in this study. Early chest SPECT was performed 10 min after intravenous injection of Tc-MIBI. Tc-MIBI chest SPECT images were qualitatively interpreted. Early tumor-to-normal lung ratios (T/NL) were calculated quantitatively. Immunohistochemical analyses were performed on multiple nonconsecutive sections of the biopsy specimens to determine Pgp expression. Chemotherapy response was evaluated in the third month after completion of treatment by clinical and radiological methods. RESULTS: All 15 (100%) cases with good response and negative Pgp expression had positive results of early Tc-MIBI chest SPECT. Ten of 15 (67%) cases with poor response and positive Pgp expression had negative results of early Tc-MIBI chest SPECT. These early T/NL ratios (3.3 +/- 0.8 for the 15 patients with good response and 2.0 +/- 0.2 for the 5 patients with poor response) in lung cancer could be detected on early Tc-MIBI chest SPECT. The difference was significant (p < 0.05) by an independent Student t test. However, no significant differences were found for other prognostic factors (age, sex, body weight loss, performance status, tumor cell type, and tumor stage) between the good and poor response groups. CONCLUSION: Early Tc-MIBI chest SPECT can be used to understand the Pgp expression in NSCLC and to quickly predict chemotherapy response to paclitaxel.
Subject(s)
Antineoplastic Agents, Phytogenic/therapeutic use , Antineoplastic Combined Chemotherapy Protocols/therapeutic use , Carcinoma, Non-Small-Cell Lung/drug therapy , Lung Neoplasms/drug therapy , Paclitaxel/therapeutic use , Phytotherapy , ATP Binding Cassette Transporter, Subfamily B, Member 1/genetics , ATP Binding Cassette Transporter, Subfamily B, Member 1/metabolism , Adult , Aged , Carcinoma, Non-Small-Cell Lung/diagnostic imaging , Carcinoma, Non-Small-Cell Lung/pathology , Female , Humans , Immunohistochemistry , Lung Neoplasms/diagnostic imaging , Lung Neoplasms/pathology , Male , Middle Aged , Neoplasm Staging , Predictive Value of Tests , Technetium Tc 99m Sestamibi , Tomography, Emission-Computed, Single-Photon , Treatment OutcomeABSTRACT
UNLABELLED: The staging of non-small-cell lung cancer (NSCLC) to detect mediastinal lymph node (MLN) metastases is very important for determining the therapeutic strategy. METHODS: Thirty-four patients with proven NSCLC were enrolled in this study. All patients underwent chest computed tomography (CT) and technetium-99m (Tc-99m) tetrofosmin chest single photon emission computed tomography (SPECT) preoperative staging. Mediastinal lymph node metastases were determined on the basis of postoperative pathologic findings to compare the diagnostic accuracy of chest CT with that of Tc-99m tetrofosmin chest SPECT. RESULTS: Tc-99m tetrofosmin chest SPECT showed a diagnostic accuracy rate of 85.3% in detecting MLN metastases. Chest CT had an accuracy rate of 73.5%. If either Tc-99m tetrofosmin chest SPECT or chest CT with positive findings was considered as positive findings, the sensitivity was 94.7%. If either Tc-99m tetrofosmin chest SPECT or chest CT with negative findings was considered as negative, the specificity was 93.3%. CONCLUSION: Tc-99m tetrofosmin chest SPECT was more accurate than chest CT in detecting MLN metastases in NSCLC patients. In addition, the combined use of Tc-99m tetrofosmin chest SPECT and chest CT could significantly increase the sensitivity and specificity compared with the single use of either Tc-99m tetrofosmin chest SPECT or chest CT.
