99mTc Tetrofosmin scintigraphy and beta-2- microglobulin in patients with lymphomas
|D. Vassileva, A. Tzonevska|
In patients with lymphoma exact diagnosis and staging is important for the treatment of these patients. 99mTc Tetrofosmin (99mTc T) is currently used to study myocardial perfusion, but also has been reported to be localized in various types of malignant tumours. 99mTc T imaging has been used in nuclear oncology, but its role in detecting lymphomas and the correlation with serum beta-2-microglobulin (β2M) has not been widely investigated. The aim of the study was to assess the clinical value of 99mTc T scintigraphy, serum beta-2-microglobulin and the correlation between them for diagnosis and therapy control of patients with Hodgkin’s disease and non- Hodgkin’s lymphoma.
128 patients with biopsy proven Hodgkin’s disease (HD) and non-Hodgkin’s lymphoma (61 men and 67 women), aged between 19 and 75 years were investigated. Scintigraphy was performed 30 minutes and 3 hours after intravenous injection of 740 MBq 99mTc T. planar and SPECT images were obtained on gamma camera Diacam (Siemens). Serum β2M levels were measured by radioimmunoassay using the Immunotech international microtest. 99mTc T scintigraphy was positive in 32 patients with MH before treatment. From 45 detected lesions, 36 were with lymph node involvement in mediastinal, hilar, neck, axillar and inguinal area and 9 were with extranodal localization. Two patients were with false negative scintigraphy, CT investigation showed enlarged lymph nodes in abdomen. One patient was with false positive scintigraphy, biopsy showed tuberculosis. Focal pathological tetrofosmin uptake was seen in 22 patients with NHL. From 31 detected lesions, 21 were with lymph node involvement in mediastinum, neck, axillar, hilar and inguinal area and 10 with extranodal localization. Four patients were with false negative scintigraphy, CT investigation showed enlarged lymph nodes in abdomen. The investigations were repeated after treatment. Sensitivityspecificity and accuracy were calculated: 95%, 100%,93% in MH and 88%,100% and 88% respectively. 99mTc Tetrofosmin scintigraphy appears sensitive diagnostic method for detecting nodal and extranodal lesions in malignant lymphomas. The positive scintigraphy showed a good correlation with a serum beta-2-microglobulin measurement in different stages of the disease.
Key words: LYMPHOMA. DIAGNOSIS AND THERAPY CONTROL.
TETROFOSMIN SCINTIGRAPHY. SERUM BETA-2-