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Dentomaxillofacial Radiology (2005) 34, 268-273
© 2005 British Institute of Radiology
doi: 10.1259/dmfr/65143191

RESEARCH

Scintigraphy for interpretation of malignant tumours of the head and neck: comparison of technetium-99m-hexakis-2-methoxyisobutylisonitrile (Tc-MIBI) and thallium-201-chloride (Tl-201)

T Sato*,1,, Y Kawabata1, Y Kobayashi2, S Suenaga1, H Indo1, K Kawano1, Y Iwashita1, Y Morita3 and HJ Majima1

1 Field of Oncology, Department of Maxillofacial Radiology, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, Japan; 2 Division of Clinical Engineering, Kagoshima University Hospital, Kagoshima, Japan; 3 Department of Oral Radiology, Tsurumi University School of Dental Medicine, Tsurumi, Japan

*Correspondence to: Tsuyoshi Sato, Department of Oncology, Maxillofacial Radiology Division, Kagoshima University Graduate School of Medical and Dental Sciences, 8-35-1 Sakuragaoka, Kagoshima 890-8544, Japan; E-mail: sato{at}denta.hal.kagoshima-u.ac.jp

Received 12 October 2004; revised 13 January 2005; accepted 20 February 2005

Objectives: The purpose of this study was to compare the usefulness of technetium-99m-hexakis-2-methoxyisobutylisonitrile (99Tcm-MIBI) and thallium-201-chloride (Tl-201) as scintigraphic agents.

Methods: Dynamic and static scintigraphic imaging with 99Tcm-MIBI and Tl-201 were performed on patients with a variety of malignant and benign tumours. Factors of the grade of the static scan, the blood flow index, the early and delayed retention indexes, and the tumour retention index were obtained from the scintigraphy. In addition to these factors, the grade of tissue differentiation and tumour size were evaluated to clarify the difference between 99Tcm-MIBI and Tl-201 for the diagnosis of malignant tumours of the head and neck.

Results: 99Tcm-MIBI accumulation depended upon the blood flow index in the early static scan, but this accumulation did not correlate with tumour size. The accumulation in most subjects decreased in the delayed static scan, and the tumour retention index had a tendency to decrease with the grade of tissue differentiation. Tl-201 accumulation depended upon the blood flow index in the early static scan similar to 99Tcm-MIBI, and the accumulation correlated with tumour size, unlike 99Tcm-MIBI. The tumour retention index had a tendency to increase with the grade of tissue differentiation. Thus, the tumour retention indexes showed opposite behaviours between 99Tcm-MIBI and Tl-201, but they both accurately determined tumour malignancy.

Conclusions: There was no major difference between 99Tcm-MIBI and Tl-201scintigraphy with respect to accuracy of diagnosis of malignant tumours of the head and neck. However, 99Tcm-MIBI was superior to Tl-201 for small-size tumours and Tl-201 was useful for large-size tumours.

Keywords: scintigraphy; 99Tcm-MIBI; Tl-201; tumour retention index






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