Nuclear Medicine Imaging of Locally Advanced Laryngeal and Hypopharyngeal Cancer

Abstract

The diagnostic capabilities of nuclear medicine imaging in the detection and assessment of the spread of laryngeal/hypopharyngeal cancer were studied. A total of 40 patients with histologically verified laryngeal and hypopharyngeal cancer and 20 patients with benign laryngeal lesions were included into the study. Submucosal injections of {99m}Tc-MIBI and {99m}Tc-Alotech were made around the tumor. Single photon emission computed tomography (SPECT) was performed 20 minutes after the injection of {99m}Tc-MIBI. Sentinel lymph nodes (SLNs) were detected in 26 patients. In 18 hours after the injection of {99m}Tc-Alotech, SPECT was performed. In 24 hours after the injection of {99m}Tc-Alotech, intraoperative SLN detection was performed using Gamma Finder II. SPECT with {99m}Tc-MIBI revealed laryngeal and hypopharyngeal tumors in 38 of the 40 patients. The {99m}Tc-MIBI uptake in metastatic lymph nodes was visualized in 2 (17%) of the 12 patients. Twenty eight SLNs were detected by SPECT and 31 SLNs were identified using the intraoperative gamma probe. The percentage of {99m}Tc-Alotech in the SLN was 5-10% of the radioactivity in the injection site by SPECT and 18-33% by intraoperative gamma probe detection. Thus, SPECT with {99m}Tc-MIBI is an effective tool for the diagnosis of laryngeal/hypopharyngeal cancer. The sensitivity, specificity and accuracy of this technique were 95%, 80% and 92%, respectively. The use of {99m}Tc-Alotech for the detection of SLNs in patients with laryngeal/hypopharyngeal cancer is characterized by 92.8% sensitivity.