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Objective: The purpose of this preliminary study was to evaluate retrospectively the relation between chemotherapy response and survival time using technetium-99m methoxyisobutylisonitrile (Tc-99m MIBI) uptake in lung cancer (small and nonsmall-cell carcinoma) and to detect the expression of multidrug resistance (mdr)-mediated P-glycoprotein (Pgp).
Design: Retrospective study on cases who have been diagnosed as lung cancer
Setting: The study group comprised 8 small-cell lung cancer (SCLC) and 6 nonsmall-cell lung cancer (NSCLC) (1 adenocarcinoma, 5 epidermoid carcinomas) cases. All cases were male, ages 49 to 68 years.
Interventions: Fourteen patients with lung cancer, prior to administration of chemotherapy (for SCLC cisplatin 60 mg/m2, etoposide 120 mg/m2 [3 days], for NSCLC cisplatin 50 mg/m2, mitomycin 6 mg/m2, Ifosfamide 3000 mg/m2 or cisplatin 20 mg/m2, vinorelbine 30 mg/m2 [1st and 8£^ days]), were enrolled in this study to undergoTc-99m MIBI chest imaging, including single photon emission computed tomography (SPECT) and planar imaging and computed tomograhy (CT), applied just before and subsequent to the 3rtl chemotherapy. Response to chemotherapy was assessed according to WHO’s criteria; completed response (CR) and partial response (PR) were defined as good responses, nonresponse (NR) and progressive diseesa (PDR) were defined as poor responses. Tumor uptake ratio (TUR) was calculated from a formula taking into account total counts in the regions of interest (ROI) over the tumor and total counts in the contralateral normal lung tissue.
Measurements and results: Thirteen of the 14 (92%) cases (6 NSCLC and 7 SCLC) could be detected by visual interpretation of Tc-99m MIBI chest SPECT images. Four patients for each cancer group completed chemotherapy. One of 4 with SCLC (25%) and 3 of 4 with NSCLC (75%) were good responders to chemotherapy. There was a significant positive correlation between tumor uptake ratio (TUR) and survival time (r= 0.73, p=0.036). The value of Tc-99m MIBI in predicting response to chemotherapy could not be demonstrated statistically. This result was possibly due to the small number of patients in the series.
Conclusion: Tc-99m MIBI chest images have the potential to predict patient survival time and prognosis in patients with lung cancer.