Value of CT thallium-201 SPECT fusion imaging over SPECT alone for detection and localization of nasopharyngeal and maxillary cancers

Tadaki Nakahara, Naoyuki Shigematsu, Masato Fujii, Etsuo Kunieda, Takayuki Suzuki, Chikako Tanaka, Jun Hashimoto, Atsushi Kubo

Research output: Contribution to journalArticle

6 Citations (Scopus)

Abstract

OBJECTIVE. The purpose of this study was to investigate the incremental clinical utility of CT and high-resolution SPECT fusion imaging. MATERIALS AND METHODS. Eighteen patients with nasopharyngeal cancer or cancers around the maxilla were scanned with high-resolution SPECT at the time of initial diagnosis (18 studies) and during follow-up after chemoradiotherapy (23 studies). SPECT results were compared with histologic findings or the findings of other imaging techniques. In addition, automatic image registration without fiducial markers was performed from CT and SPECT data, and the effect of fusion imaging on the localization of abnormalities was evaluated. RESULTS. All of the original 18 untreated lesions showed high uptake. Recurrent tumors had a tendency to show high uptake (seven of nine patients), whereas little or no uptake generally represented no recurrence (12 of 14 patients) (chi-square test with Yates correction: χ2 = 6.80, p < 0.01). In two patients, physiologic uptake in the unilateral prevertebral muscle was revealed on image fusion. In four of the nine recurrent nasopharyngeal cancers (44%), SPECT alone could not determine abnormalities in uptake sites, whereas CT/SPECT fusion imaging clearly localized the sites and was helpful for treatment strategy. CONCLUSION. High-resolution thallium-201 (201Tl) SPECT has a very high detection rate in patients with nasopharyngeal cancer and cancers around the maxilla. However, the anatomic identification or localization of the uptake sites is sometimes difficult without CT/SPECT fusion imaging. This technique without external markers is practically feasible to generate clinically valid fusion images.

Original languageEnglish
Pages (from-to)825-829
Number of pages5
JournalAmerican Journal of Roentgenology
Volume187
Issue number3
DOIs
Publication statusPublished - 2006 Sep

Fingerprint

Nasopharyngeal Neoplasms
Thallium
Single-Photon Emission-Computed Tomography
Maxilla
Fiducial Markers
Neoplasms
Chemoradiotherapy
Chi-Square Distribution
Recurrence
Muscles
Single Photon Emission Computed Tomography Computed Tomography

Keywords

  • CT
  • Head and neck imaging
  • Image fusion
  • Maxillary cancer
  • Nasopharyngeal cancer
  • Nuclear imaging
  • SPECT
  • Thallium-201

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging
  • Radiological and Ultrasound Technology

Cite this

Value of CT thallium-201 SPECT fusion imaging over SPECT alone for detection and localization of nasopharyngeal and maxillary cancers. / Nakahara, Tadaki; Shigematsu, Naoyuki; Fujii, Masato; Kunieda, Etsuo; Suzuki, Takayuki; Tanaka, Chikako; Hashimoto, Jun; Kubo, Atsushi.

In: American Journal of Roentgenology, Vol. 187, No. 3, 09.2006, p. 825-829.

Research output: Contribution to journalArticle

Nakahara, Tadaki ; Shigematsu, Naoyuki ; Fujii, Masato ; Kunieda, Etsuo ; Suzuki, Takayuki ; Tanaka, Chikako ; Hashimoto, Jun ; Kubo, Atsushi. / Value of CT thallium-201 SPECT fusion imaging over SPECT alone for detection and localization of nasopharyngeal and maxillary cancers. In: American Journal of Roentgenology. 2006 ; Vol. 187, No. 3. pp. 825-829.
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AU - Shigematsu, Naoyuki

AU - Fujii, Masato

AU - Kunieda, Etsuo

AU - Suzuki, Takayuki

AU - Tanaka, Chikako

AU - Hashimoto, Jun

AU - Kubo, Atsushi

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AB - OBJECTIVE. The purpose of this study was to investigate the incremental clinical utility of CT and high-resolution SPECT fusion imaging. MATERIALS AND METHODS. Eighteen patients with nasopharyngeal cancer or cancers around the maxilla were scanned with high-resolution SPECT at the time of initial diagnosis (18 studies) and during follow-up after chemoradiotherapy (23 studies). SPECT results were compared with histologic findings or the findings of other imaging techniques. In addition, automatic image registration without fiducial markers was performed from CT and SPECT data, and the effect of fusion imaging on the localization of abnormalities was evaluated. RESULTS. All of the original 18 untreated lesions showed high uptake. Recurrent tumors had a tendency to show high uptake (seven of nine patients), whereas little or no uptake generally represented no recurrence (12 of 14 patients) (chi-square test with Yates correction: χ2 = 6.80, p < 0.01). In two patients, physiologic uptake in the unilateral prevertebral muscle was revealed on image fusion. In four of the nine recurrent nasopharyngeal cancers (44%), SPECT alone could not determine abnormalities in uptake sites, whereas CT/SPECT fusion imaging clearly localized the sites and was helpful for treatment strategy. CONCLUSION. High-resolution thallium-201 (201Tl) SPECT has a very high detection rate in patients with nasopharyngeal cancer and cancers around the maxilla. However, the anatomic identification or localization of the uptake sites is sometimes difficult without CT/SPECT fusion imaging. This technique without external markers is practically feasible to generate clinically valid fusion images.

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