TC multistrato e SPECT-TC con Tc-99m Sestamibi

Diagnostica integrate nella caratterizzazione del nodulo polmonare solitario

Translated title of the contribution: Integrated multislice CT and Tc-99m Sestamibi SPECT-CT evaluation of solitary pulmonary nodules

G. Sergiacomi, O. Schillaci, M. Leporace, F. Laviani, M. Carlani, C. Manni, R. Danieli, G. Simonetti

Research output: Contribution to journalArticle

17 Citations (Scopus)

Abstract

Purpose. The purpose of this study was to evaluate efficacy of multislice computed tomography (MSCT) and single photon emission computed tomography (SPECT)-CT with Tc-99m Sestamibi in the assessment of solitary pulmonary nodules of uncertain significance. Scintigraphy was performed using a 'hybrid' g-camera that allows simultaneous acquisition of SPECT and CT images, with interesting results in diagnostic oncology. Materials and methods. Between September 2003 and August 2004, 23 patients with a solitary pulmonary nodule detected on CT underwent SPECT-CT using Tc-99m Sestamibi as a radiotracer. Nodules with positive scintigraphy were immediately subjected to biopsy or surgical resection. Nodules with negative scintigraphy were followed up after 3-4 months by MSCT with automatic segmentation software (Advanced Lung Analysis, ALA) and histological characterisation. Results. Of the 23 nodules (size range 0.8-2 cm) discovered with MSCT, 11 showed intense uptake of Tc-99m Sestamibi. Ten lesions were true positive: seven adenocarcinomas, one squamous cell carcinoma, one large cell carcinoma and one metastasis. The only false positive was histologically classified as a large cell granuloma. Twelve lesions had negative scintigraphy: five fibrous lesions, three hamartomas, three granulomas and one adenocarcinoma (false negative). Benign nodules without tracer uptake underwent another CT scan 3-4 months later, which confirmed stability of the nodule size. Correlation of Sestamibi SPECT with histology showed sensitivity (Se) of 90.9 %, specificity (Sp) of 91.6 %, diagnostic accuracy of 91.3 %, positive predictive value (PPV) of 90.9% and negative predictive value (NPV) of 91.6%. Conclusions. The integrated use of MSCT and Tc-99m Sestamibi SPECT-CT could be very useful in the management of solitary pulmonary nodules (SPNs). In particular, in our preliminary study, scintigraphy provided significant diagnostic information to differentiate benign from suspicious pulmonary nodules. The use of scintigraphy could be helpful to anticipate histological assessment and surgical treatment of SPNs identified at CT.

Original languageItalian
Pages (from-to)213-224
Number of pages12
JournalRadiologia Medica
Volume111
Issue number2
DOIs
Publication statusPublished - Mar 2006

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Solitary Pulmonary Nodule
Single-Photon Emission-Computed Tomography
Radionuclide Imaging
Multidetector Computed Tomography
Granuloma
Adenocarcinoma
Large Cell Carcinoma
Lung
Hamartoma
Squamous Cell Carcinoma
Histology
Software
Neoplasm Metastasis
Biopsy
Sensitivity and Specificity

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging

Cite this

Sergiacomi, G., Schillaci, O., Leporace, M., Laviani, F., Carlani, M., Manni, C., ... Simonetti, G. (2006). TC multistrato e SPECT-TC con Tc-99m Sestamibi: Diagnostica integrate nella caratterizzazione del nodulo polmonare solitario. Radiologia Medica, 111(2), 213-224. https://doi.org/10.1007/s11547-006-0022-7

TC multistrato e SPECT-TC con Tc-99m Sestamibi : Diagnostica integrate nella caratterizzazione del nodulo polmonare solitario. / Sergiacomi, G.; Schillaci, O.; Leporace, M.; Laviani, F.; Carlani, M.; Manni, C.; Danieli, R.; Simonetti, G.

In: Radiologia Medica, Vol. 111, No. 2, 03.2006, p. 213-224.

Research output: Contribution to journalArticle

Sergiacomi, G, Schillaci, O, Leporace, M, Laviani, F, Carlani, M, Manni, C, Danieli, R & Simonetti, G 2006, 'TC multistrato e SPECT-TC con Tc-99m Sestamibi: Diagnostica integrate nella caratterizzazione del nodulo polmonare solitario', Radiologia Medica, vol. 111, no. 2, pp. 213-224. https://doi.org/10.1007/s11547-006-0022-7
Sergiacomi, G. ; Schillaci, O. ; Leporace, M. ; Laviani, F. ; Carlani, M. ; Manni, C. ; Danieli, R. ; Simonetti, G. / TC multistrato e SPECT-TC con Tc-99m Sestamibi : Diagnostica integrate nella caratterizzazione del nodulo polmonare solitario. In: Radiologia Medica. 2006 ; Vol. 111, No. 2. pp. 213-224.
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abstract = "Purpose. The purpose of this study was to evaluate efficacy of multislice computed tomography (MSCT) and single photon emission computed tomography (SPECT)-CT with Tc-99m Sestamibi in the assessment of solitary pulmonary nodules of uncertain significance. Scintigraphy was performed using a 'hybrid' g-camera that allows simultaneous acquisition of SPECT and CT images, with interesting results in diagnostic oncology. Materials and methods. Between September 2003 and August 2004, 23 patients with a solitary pulmonary nodule detected on CT underwent SPECT-CT using Tc-99m Sestamibi as a radiotracer. Nodules with positive scintigraphy were immediately subjected to biopsy or surgical resection. Nodules with negative scintigraphy were followed up after 3-4 months by MSCT with automatic segmentation software (Advanced Lung Analysis, ALA) and histological characterisation. Results. Of the 23 nodules (size range 0.8-2 cm) discovered with MSCT, 11 showed intense uptake of Tc-99m Sestamibi. Ten lesions were true positive: seven adenocarcinomas, one squamous cell carcinoma, one large cell carcinoma and one metastasis. The only false positive was histologically classified as a large cell granuloma. Twelve lesions had negative scintigraphy: five fibrous lesions, three hamartomas, three granulomas and one adenocarcinoma (false negative). Benign nodules without tracer uptake underwent another CT scan 3-4 months later, which confirmed stability of the nodule size. Correlation of Sestamibi SPECT with histology showed sensitivity (Se) of 90.9 {\%}, specificity (Sp) of 91.6 {\%}, diagnostic accuracy of 91.3 {\%}, positive predictive value (PPV) of 90.9{\%} and negative predictive value (NPV) of 91.6{\%}. Conclusions. The integrated use of MSCT and Tc-99m Sestamibi SPECT-CT could be very useful in the management of solitary pulmonary nodules (SPNs). In particular, in our preliminary study, scintigraphy provided significant diagnostic information to differentiate benign from suspicious pulmonary nodules. The use of scintigraphy could be helpful to anticipate histological assessment and surgical treatment of SPNs identified at CT.",
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AU - Leporace, M.

AU - Laviani, F.

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AU - Danieli, R.

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N2 - Purpose. The purpose of this study was to evaluate efficacy of multislice computed tomography (MSCT) and single photon emission computed tomography (SPECT)-CT with Tc-99m Sestamibi in the assessment of solitary pulmonary nodules of uncertain significance. Scintigraphy was performed using a 'hybrid' g-camera that allows simultaneous acquisition of SPECT and CT images, with interesting results in diagnostic oncology. Materials and methods. Between September 2003 and August 2004, 23 patients with a solitary pulmonary nodule detected on CT underwent SPECT-CT using Tc-99m Sestamibi as a radiotracer. Nodules with positive scintigraphy were immediately subjected to biopsy or surgical resection. Nodules with negative scintigraphy were followed up after 3-4 months by MSCT with automatic segmentation software (Advanced Lung Analysis, ALA) and histological characterisation. Results. Of the 23 nodules (size range 0.8-2 cm) discovered with MSCT, 11 showed intense uptake of Tc-99m Sestamibi. Ten lesions were true positive: seven adenocarcinomas, one squamous cell carcinoma, one large cell carcinoma and one metastasis. The only false positive was histologically classified as a large cell granuloma. Twelve lesions had negative scintigraphy: five fibrous lesions, three hamartomas, three granulomas and one adenocarcinoma (false negative). Benign nodules without tracer uptake underwent another CT scan 3-4 months later, which confirmed stability of the nodule size. Correlation of Sestamibi SPECT with histology showed sensitivity (Se) of 90.9 %, specificity (Sp) of 91.6 %, diagnostic accuracy of 91.3 %, positive predictive value (PPV) of 90.9% and negative predictive value (NPV) of 91.6%. Conclusions. The integrated use of MSCT and Tc-99m Sestamibi SPECT-CT could be very useful in the management of solitary pulmonary nodules (SPNs). In particular, in our preliminary study, scintigraphy provided significant diagnostic information to differentiate benign from suspicious pulmonary nodules. The use of scintigraphy could be helpful to anticipate histological assessment and surgical treatment of SPNs identified at CT.

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