Double-phase Tc-99m MIBI scintigraphy as a therapeutic predictor in patients with non-Hodgkin's lymphoma.

Abstract

PURPOSE:

Tc-99m MIBI is a promising agent for the functional characterization of P-glycoprotein expression and the prediction of therapeutic outcome in human tumors. The purpose of this study was to determine whether tumor clearance of Tc-99m MIBI may have a predictive value in the clinical outcome in patients with non-Hodgkin's lymphoma.

METHODS:

Seventeen patients with histologically proved non-Hodgkin's lymphoma underwent Tc-99m MIBI scintigraphy before starting chemotherapy. Early and late images were obtained after the injection of 740 MBq (20 mCi) Tc-99m MIBI. Tumor-to-normal soft tissue ratios were measured on early and late images, and the percentage retention (%R) was calculated. These findings were correlated with other prognostic factors.

RESULTS:

Of all 40 tumor lesions, 22 (55%) showed Tc-99m MIBI tumor uptake, whereas the other 18 (45%) lesions had no uptake. According to the location, the diagnostic accuracy of Tc-99m MIBI scans was 66.7% (12 of 18) for lesions of the head and neck, 66.7% (8 of 12) for those of the chest, and 20% (2 of 10) for those of subdiaphragmatic regions (P = 0.037). The mean %R of complete responders was 91.8 +/- 14.8% and for partial responders or nonresponders it was 65.4 +/- 17.7% (P = 0.014). The %R of Tc-99m MIBI showed a significant negative correlation with the serum lactate dehydrogenase level (r = -0.757), the score of the international prognostic index (r = -0.643), and the Ann Arbor stage (r = -0.733).

CONCLUSION:

The slow tumor clearance of Tc-99m MIBI can predict a good response to chemotherapy in patients with non-Hodgkin's lymphoma and differentiate responding and nonresponding tumors early in the course of chemotherapy.

• Authors: Ho-Chun Song, Je-Jung Lee, Hee-Seung Bom, Ik-Joo Chung, Hyeoung-Joon Kim, Young-Kyu Park, E Edmund Kim
• Journal: Clinical nuclear medicine (Clin Nucl Med) Vol. 28 Issue 6 Pg. 457-62 (Jun 2003) ISSN: 0363-9762 [Print] United States
• PMID: 12911092 (Publication Type: Journal Article)

Chemical References

• Radiopharmaceuticals
• Technetium Tc 99m Sestamibi
• L-Lactate Dehydrogenase

Topics

• Antineoplastic Combined Chemotherapy Protocols (therapeutic use)
• Female
• Humans
• L-Lactate Dehydrogenase (blood)
• Lymphoma, Non-Hodgkin (diagnostic imaging, drug therapy)
• Male
• Middle Aged
• Predictive Value of Tests
• Prognosis
• Prospective Studies
• Radionuclide Imaging
• Radiopharmaceuticals
• Technetium Tc 99m Sestamibi
• Treatment Outcome