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NUCLEAR MEDICINE IMAGING IN THE DETECTION OF LOCALLY ADVANCED LARYNGEAL AND HYPOPHARYNGEAL CANCER

https://doi.org/10.21294/1814-4861-2017-16-6-57-66

Abstract

Introduction. The choice of adequate treatment for cancer patients and their survival rates signifcantly depend on the precise detection of the primary tumor and the assessment of the extent of cancer involvement. Despite advances in the treatment of laryngeal/hypopharyngeal cancer, many aspects of this problem are still unresolved. The purpose of the study. Diagnostic capabilities of nuclear medicine imaging in the detection and assessment of the spread of laryngeal/hypopharyngeal cancer were studied. Material and methods. The study included 40 patients with histologically verifed laryngeal/ hypopharyngeal cancer, 10 patients with tumor recurrence after completion of therapy and 20 patients with benign laryngeal lesions. Single photon emission computed tomography (SPECT) was performed 20 minutes after the injection of 99mTc-methoxy-isobutyl-isonitrile (MIBI). Sentinel lymph nodes (SLNs) were detected in 26 patients after submucosal injections of 99mTc-Tehneft or 99mTc-Alotech around the tumor. In 18 hours after the injection of 99mTc-Tehneft and 99mTc-Alotech, SPECT was performed. In 24 hours after the injection of 99mTc-Tehneft and 99mTc-Alotech, intraoperative SLN detection was performed using Gamma Finder II. Results. SPECT with 99mTc-MIBI revealed laryngeal and hypopharyngeal tumors in 38 of the 40 patients. The 99mTc-MIBI uptake in metastatic lymph nodes was visualized in 2 (17 %) of the 12 patients. 28 SLNs were detected by SPECT and 31 SLNs were identifed using the intraoperative gamma probe. The percentage of lymphotropic radiopharmaceuticals in the SLN was 5–10 % of the radioactivity in the injection site by SPECT and 12–33 % by intraoperative gamma probe detection. Conclusion. SPECT with 99mTc-MIBI is an effective tool for the diagnosis of laryngeal/hypopharyngeal cancer. The sensitivity, specifcity and accuracy of this technique were 95, 80 and 92 %, respectively. The use of 99mTc-Tehnefte and 99mTc-Alotech for the detection of SLN in laryngeal/hypopharyngeal cancer patients was characterized by high effcacy, while intraoperative detection was more sensitive, being 80 and 100 %, respectively.

About the Authors

A. A. Medvedeva
Cancer Research Institute, Tomsk National Research Medical Center, Russian Academy of Sciences, Tomsk
Russian Federation

MD, PhD, Senior Researcher

SPIN-code: 9110-1730



V. I. Chernov
Cancer Research Institute, Tomsk National Research Medical Center, Russian Academy of Sciences, Tomsk; National Research Tomsk Polytechnic University, Tomsk
Russian Federation

MD, DSc, Professor, Deputy Director for Science and Innovation, Head of Nuclear Medicine Department

SPIN-code: 6301-3612



R. V. Zeltchan
Cancer Research Institute, Tomsk National Research Medical Center, Russian Academy of Sciences, Tomsk
Russian Federation

MD, PhD, Radiologist, Nuclear Medicine Department

SPIN-code: 2255-5282.



I. G. Sinilkin
Cancer Research Institute, Tomsk National Research Medical Center, Russian Academy of Sciences, Tomsk
Russian Federation

MD, PhD, Senior Researcher, Nuclear Medicine Department

SPIN-code: 7254-3474



I. G. Frolova
Cancer Research Institute, Tomsk National Research Medical Center, Russian Academy of Sciences, Tomsk
Russian Federation

MD, DSc, Professor, Head of the Diagnostic Imaging Department

SPIN-code: 9800-9777



S. V. Chizevskaya
Cancer Research Institute, Tomsk National Research Medical Center, Russian Academy of Sciences, Tomsk
Russian Federation

MD, DSc, Senior Researcher, Department of Head and Neck Tumors

SPIN-code: 9561-3382



E. L. Choynzonov
Cancer Research Institute, Tomsk National Research Medical Center, Russian Academy of Sciences, Tomsk; Siberian State Medical University, Tomsk
Russian Federation

MD, DSc, Professor, Member of the Russian Academy of Sciences, Professor, Director of Tomsk National Research Medical Cancer of the Russian Academy of Sciences; Head of Oncology Department of Siberian State Medical University (Tomsk, Russia)

SPIN-code: 2240-8730



O. V. Cheremisina
Cancer Research Institute, Tomsk National Research Medical Center, Russian Academy of Sciences, Tomsk
Russian Federation

MD, DSc, Head of Endoscopy Department

SPIN-code: 9579-2691



A. V. Goldberg
Cancer Research Institute, Tomsk National Research Medical Center, Russian Academy of Sciences, Tomsk
Russian Federation

MD, Junior Researcher

SPIN-code: 4415-0138



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Review

For citations:


Medvedeva A.A., Chernov V.I., Zeltchan R.V., Sinilkin I.G., Frolova I.G., Chizevskaya S.V., Choynzonov E.L., Cheremisina O.V., Goldberg A.V. NUCLEAR MEDICINE IMAGING IN THE DETECTION OF LOCALLY ADVANCED LARYNGEAL AND HYPOPHARYNGEAL CANCER. Siberian journal of oncology. 2017;16(6):57-66. (In Russ.) https://doi.org/10.21294/1814-4861-2017-16-6-57-66

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ISSN 1814-4861 (Print)
ISSN 2312-3168 (Online)