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 TACTICS

V.I. Amosov; Pavlov First Saint-Petersburg Federal State Medical University; A.O. Agaphonov; V.P. Zolotnitskaya; Pavlov First Saint-Petersburg Federal State Medical University; Pavlov First Saint-Petersburg Federal State Medical University

doi:10.21569/2222-7415-2018-8-4-73-82

espite 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 Gallium citrate-67. Materials and methods. The results of a comprehensive radiological

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... n 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 results 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 performing 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 accumulation 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 vascular channel, which helps in determining the treatment tactics, including surgical treatment. The use of SPECT with Gallium-67 helps in identifying regional and distant metastasis, but in some cases false positive data are determined, due to concomitant inflammatory changes.

doi:10.21569/2222-7415-2018-8-4-73-82 fatcat:g25tbn7dv5ejlcwlwhw3y3vo3y

Citation

V.I. Amosov, Pavlov First Saint-Petersburg Federal State Medical University, A.O. Agaphonov, V.P. Zolotnitskaya, Pavlov First Saint-Petersburg Federal State Medical University, Pavlov First Saint-Petersburg Federal State Medical University. "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 TACTICS." Russian Electronic Journal of Radiology 8.4 (2018) 73-82

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