%A Jing CHEN MD, Guang-Yuan HU MD, Guo-Qing HU MD, Hua WU PhD, %T Technetium-99m-sestamibi SPECT for the diagnosis and follow-up of nasopharyngeal carcinoma %0 Journal Article %D 2010 %J Front. Med. %J Frontiers of Medicine %@ 2095-0217 %R 10.1007/s11684-010-0001-1 %P 96-100 %V 4 %N 1 %U {https://journal.hep.com.cn/fmd/EN/10.1007/s11684-010-0001-1 %8 2010-03-05 %X This study was to investigate a better way to detect and differentiate primary, residual, recurrent nasopharyngeal carcinoma (NPC) lesions post-radiotherapy in patients with NPC by means of routine computed tomography (CT) in combination with 99Tcm-sestamibi single photon emission computed tomography (99Tcm-MIBI SPECT). Forty-eight patients with histologically confirmed primary NPC underwent 99Tcm-MIBI SPECT at the 3rd month before and after radiotherapy, and at the 6th month after radiotherapy. All patients had contemporaneous CT examinations. Histopathologic results and/or clinical follow-up data (over 18 months) were used as the golden standard for evaluating residual/recurrent lesions. The radioactive count ratio of nasopharynx to scalp was obtained as the MIBI uptake index (MUI). Receiver operating characteristic analysis was employed to define the cut-off value of MUI for malignancy. With MUI 2.15 as the cut-off point, the accuracy for detecting primary NPC was 94.12%. The mean MUI in the local-regional of the nasopharynx in such negative cases was 1.21±€0.12 at the 3rd month, while the mean MUI was higher in the other 15 patients with histologically confirmed recurrent/residual lesions (MUI=1.40€±€0.16, t=4.71, P<0.001). The optimal cut-off point of 1.33 of MUI was defined with 89.58% accuracy for differentiating residual/recurrent lesions from the benign process post radiotherapy, while CT evaluations showed an accuracy of 81.25%. A combination of CT and 99Tcm-MIBI SPECT for 37 NPC patients with congruent results showed an accuracy of 97.30% for differentiating residual/recurrent NPC from benign lesions. 99Tcm-MIBI SPECT plays a role in evaluating residual/recurrent lesions post-radiotherapy. The combination of CT and 99Tcm-MIBI SPECT can give more accurate diagnosis in the follow-up of NPC.