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Predicting Early Chemotherapy Response with Technetium-99m Methoxyisobutylisonitrile SPECT/CT in Advanced Non-Small Cell Lung Cancer

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Abstract

Purpose

The purpose of this study is to examine the prognostic value of prechemotherapy technetium-99m methoxyisobutylisonitrile (99mTc-MIBI) uptake with single photon emission computed tomography/computed tomography (SPECT/CT) in relation to tumor size change measured by CT.

Methods

Eleven patients with stage IIIB/IV non-small cell lung cancer (NSCLC) underwent 99mTc-MIBI SPECT/CT within 24 h before starting platinum-containing chemotherapy. Following the Response Evaluation Criteria in Solid Tumors guidelines, 20 lesions from the 11 patients were available for evaluation. Maximum (C max) and mean (C mean) MIBI counts were calculated for each lesion. One-dimensional (1D; longest diameter) and two-dimensional (2D; area of the largest transverse surface) tumor measurements were assessed by two observers on the diagnostic CT and the response assessment CT after two cycles of chemotherapy.

Results

Bland–Altman analysis demonstrated no clinically significant bias between the observers. A solid correlation was found between 99mTc-MIBI C mean and change in the longest diameter (1D change) of the target lesion (ρ = −0.62) using Spearman’s rank correlation test. C mean also correlated negatively with change in the area of the largest transverse surface (2D change) of the target lesion (ρ = −0.53). Furthermore, a correlation was established between 99mTc-MIBI C max and 1D change (ρ = −0.56) in tumor size as well, though less strongly when compared to its C mean counterpart.

Conclusions

Our series demonstrated solid, negative correlations between prechemotherapy 99mTc-MIBI uptake and tumor size change measured by CT for advanced NSCLC, particularly with C mean and 1D change.

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Acknowledgements

We would like to thank the technical staff of the Department of Nuclear Medicine, The Netherlands Cancer Institute–Antoni van Leeuwenhoek Hospital for performing the SPECT/CT imaging in this study.

Conflict of interest notification

The authors of this manuscript have no actual or potential conflicts of interest to disclose.

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Authors and Affiliations

  1. Department of Radiotherapy, The Netherlands Cancer Institute–Antoni van Leeuwenhoek Hospital, Plesmanlaan 121, 1066 CX, Amsterdam, The Netherlands

    Tzu-I J. Yang & Marcel Verheij

  2. Yale University School of Medicine, New Haven, CT, USA

    Tzu-I J. Yang

  3. Department of Nuclear Medicine, The Netherlands Cancer Institute–Antoni van Leeuwenhoek Hospital, Amsterdam, The Netherlands

    Tjeerd S. Aukema & Renato Valdés Olmos

  4. Biometrics Department, The Netherlands Cancer Institute–Antoni van Leeuwenhoek Hospital, Amsterdam, The Netherlands

    Harm van Tinteren

  5. Department of Thoracic Oncology, The Netherlands Cancer Institute–Antoni van Leeuwenhoek Hospital, Amsterdam, The Netherlands

    Sjaak Burgers

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  1. Tzu-I J. Yang
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  2. Tjeerd S. Aukema
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Correspondence to Marcel Verheij.

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Yang, TI.J., Aukema, T.S., van Tinteren, H. et al. Predicting Early Chemotherapy Response with Technetium-99m Methoxyisobutylisonitrile SPECT/CT in Advanced Non-Small Cell Lung Cancer. Mol Imaging Biol 12, 174–180 (2010). https://doi.org/10.1007/s11307-009-0250-z

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  • DOI: https://doi.org/10.1007/s11307-009-0250-z

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