Possibilities of single-photon emission tomography using 99MTC-MAA and citrate GA-67 in assessing the prevalence of lung cancer at the stage of the choice of surgical intervention tac-tics.

Amosov V.I., Agaphonov A.O., Zolotnitskaya V.P.

Despite the possibilities of modern methods of radiology, imperfection of the algorithms for the timely diagnosis of lung cancer determines the problem of the relevant assessment of the prevalence of lung cancer at the preoperative stage. Purpose. To analyze the possibility of using modern radiology methods in assessing the prevalence of lung cancer based on the use of CT and SPECT with 99mTc-MAA and Gal-lium citrate-67. Materials and methods. The results of a comprehensive radiological examination of 69 patients with lung cancer (41 patients (59.4%) - with central lung cancer, with peripheral lung cancer - 28 (40.6%)). Patients underwent a CT study with multiphase bolus contrast (n = 69 patients), SPECT with 99mTc-MAA (n = 60 patients) and SPECT with Gallium-67 (n = 9 patients). The prevailing number of patients were patients with stage III (52 people), with stage IV - 11 people, with stages I-II - 3 people. Results. CT reliably classified the T-stage of the tumor - in 56 operated patients, the stage was overestimated - in 7 patients, underestimated - in 6 patients. Based on the re-sults of SPECT, microcirculation disorders were observed in all patients, the severity of blood flow disorders was more significant than the volume of lesion of the lung tissue when per-forming CT. In 10 cases, blood flow impairment was recorded only by the results of SPECT with 99mTc-MAA, despite the relative safety of the vascular channel during CT angiography. A study with Ga-67 citrate revealed foci of hyperfixation of the drug, 1-2 degrees of accumu-lation in tumor formation in all 9 cases. Accumulation of radiopharmaceuticals was detected in regional lymphatic nodules in 6 cases, with false-positive result in 3 patients. Conclusions. The use of SPECT with 99mTc-MAA makes it possible to supplement CT data, assess the functional state of the lungs and to visualize the destruction of the vas-cular channel, which helps in determining the treatment tactics, including surgical treat-ment. The use of SPECT with Gallium-67 helps in identifying regional and distant metasta-sis, but in some cases false positive data are determined, due to concomitant inflammatory changes.
Pavlov First Saint-Petersburg Federal State Medical University of State Educational Institu-tion of Higher Professional Education “First St.-Petersburg State Medical University

 

 

Keywords: computed tomography, single photon emission computed tomography, gal-lium citrate, lung cancer.

 

Corresponding author: Zolotnitskaia V.P. e-mail: Этот e-mail адрес защищен от спам-ботов, для его просмотра у Вас должен быть включен Javascript

For citation: Amosov V.I., Agaphonov A.O., Zolotnitskaya V.P. Possibilities of single-photon emission tomography using 99MTC-MAA and citrate GA-67 in assessing the preva-lence of lung cancer at the stage of the choice of surgical intervention tactics. REJR 2018; 8(4):73-82. DOI:10.21569/2222-7415-2018-8-4-73-82.

Received:24.10.18Accepted:11.11.18