Diagnostic Value of ¹²³I-IMT SPECT in the Follow-up of Head and Neck Cancer

Abstract

Background: Nuclear medicine imaging is increasingly used in the evaluation of tumors of the head and neck. In the current study, we assess the value of single-photon emission tomography (SPECT) using the amino acid tracer L-3-[123I]iodine-a-methyl-tyrosine (IMT) for the detection of recurrent head and neck cancer. Patients and Methods: 45 consecutive patients with suspected recurrence of previously treated head and neck cancer were examined by IMT-SPECT using a dual head system with integrated low-dose computed tomography (CT). The accuracy of the IMT-SPECT was evaluated by correlating the findings with results of histology or clinical and CT/MRI (magnetic resonance imaging) follow-up examinations. Results: The sensitivity, specificity and accuracy of IMT-SPECT in the detection of recurrent/persistent tumors were 83, 89 and 84.5%, respectively. The positive and negative predictive value amounted to 96.5 and 60%, respectively. Conclusion: IMT-SPECT using integrated low-dose CT appears to be a helpful complementary imaging tool for the detection of local recurrences and lymph node metastases of head and neck cancer and their differentiation from treatment-induced changes. The advantage of the method is the high positive predictive value in the diagnosis of relapsed tumors. However, a negative IMT-SPECT result does not exclude a recurrence.

Technological Development and Advances in Single-Photon Emission Computed Tomography/Computed Tomography

“…Clinical Applications of SPECT/CT Cited Anatomical/Disease Site Radiopharmaceutical SPECT/CT Application Adrenal masses 123 I-metaiodobenzylguanidine, 75 Se-cholesterol Anatomical localization [161] Biliary leak 99m Tc-diisopropyl iminodiacetic acid Anatomical localization [141] Bone scintigraphy 99m Tc-methylene diphosphonate, 99m Tc-dicarboxypropane diphosphonate Anatomical localization, attenuation correction [162][163][164][165][166][167][168][169] Brain cancer 99m Tc-tetrofosmin Anatomical localization [170] Breast cancer 99m Tc-sestamibi Anatomical localization [171] Colorectal cancer 99m Tc-labelled macroaggregated albumin Hepatic artery infusion of chemotherapy [172] Coronary artery calcification 99m Tc-tetrofosmin Head/neck cancer L-3-123 I-iodine-alpha-methyl-tyrosine, 123 I-labeled L19(scFv)2 antibody Anatomical localization [175][176][177] Hepatic haemangioma 99m Tc-labelled red blood cells Anatomical localization [178,179] Hepatic carcinoma 99m Tc-macroaggregated albumin Anatomical localization [180] Human immunodeficiency virus (HIV) 99m Tc-sulfur colloid Anatomical localization of microbicide surrogate [138] Infection Gallium-67, 111 In-labeled leukocytes Anatomical localization [133][134][135][136] Left ventricular function 99m Tc-tetrofosmin Regional wall motion evaluation, myocardial muscle mass, ejection fraction, cardiac volumes [118] Lung (ventilation/perfusion) 99m Tc-Technegas, 99m Tc-macroaggregated albumin Anatomical localization and registration of ventilation-perfusion patterns [139,140] Lung cancer 99m Tc-sestamibi, 99m Tc-depreotide Anatomical localization [181][182]…”