JOURNAL ARTICLE

The usefulness of 99mTc-tetrofosmin SPECT in monitoring the response to chemotherapy in lung cancer patients

Angela Spanu, Francesco Ginesu, Pietro Pirina, Orazio Schillaci, Antonio Farris, Francesca Chessa, Giordano Madeddu, Antonio Falchi, Giuseppe Madeddu
Oncology Reports 2003, 10 (6): 1701-7
14534682
We evaluated the usefulness of 99mTc-tetrofosmin (TF) scintigraphy in monitoring chemotherapy response in 31 inoperable lung cancer (LC) patients, 24 NSCLC and 7 SCLC. In all cases after 740 MBq 99mTc-TF i.v. injection both planar and SPECT images were acquired, before and after 3 cycles of chemotherapy; SPECT was analysed both qualitatively and semiquantitatively by calculating tumor/background ratio (T/B). Scintigraphic data were always related to CT findings, according to which patients were classified into 2 groups after therapy: responders (with >or=50% reduction in tumor size) and non-responders (with an increase or no change/no significant reduction in tumor size). Four patients were rechecked for the third time, during long-term follow-up. SPECT images, positive before therapy in all cases, were concordant with CT in assessing treatment response in 13/13 responders and in 18/18 non-responder patients, showing tumor reduction in the former and an increase or no change/no significant reduction in the latter. Planar imaging failed to give additional information but also led to disease down-staging in some cases. T/B ratio significantly decreased after therapy (1.67+/-0.39 vs. 3.02+/-0.87, p<0.005) in responders <or=1.9 in each patient except one with local disease progression at the third observation. No significant difference in T/B ratio was found in non-responders after treatment (2.11+/-0.65 vs. 2.13+/-0.60), with variable results in single patients, including a T/B ratio reduction in some cases, one of which with local disease remission at third observation. Moreover, pre-therapy T/B ratio was significantly higher (p<0.01) in responders than in non-responders. 99mTc-TF SPECT, but not planar, may be useful in monitoring the chemotherapy response in inoperable LC patients; the additional use of T/B ratio seems to give more accurate information and may be useful for treatment response prediction and for better evaluating disease progression or regression after therapy.

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