Solitary pulmonary nodule evaluation with 99mTc-methoxy isobutyl isonitrile in a tuberculosis-endemic area

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dc.contributor.authorSchuurmans M.M.
dc.contributor.authorEllmann A.
dc.contributor.authorBouma H.
dc.contributor.authorDiacon A.H.
dc.contributor.authorDyckmans K.
dc.contributor.authorBolliger C.T.
dc.date.accessioned2011-05-15T16:16:23Z
dc.date.available2011-05-15T16:16:23Z
dc.date.issued2007
dc.description.abstractHigh prevalence of tuberculosis increases the odds for nonmalignant solitary pulmonary nodules (SPNs). Positron emission tomography (PET) using 18F-fluorodeoxyglucose is the method of choice for the identification of malignant SPNs requiring curative surgery. However, PET is not widely available. Technetium-99m methoxy isobutyl isonitrile (MIBI) is inexpensive, widely available and shows increased uptake in malignant SPNs. The aim of the present study was to prospectively evaluate the diagnostic value of MIBI single photon emission computed tomography to distinguish between benign and malignant SPNs in a tuberculosis-endemic area. In total, 49 patients with radiologically indeterminate SPNs (single lesion ≤6 cm in diameter) were prospectively evaluated with MIBI. The final diagnosis was established with bronchoscopy, fine-needle aspiration, surgical resection or clinical follow-up for ≥2 yrs. A total of 12 (92%) out of 13 malignant lesions showed increased uptake of MIBI, while no uptake was observed in 33 (92%) out of 36 benign lesions. MIBI uptake indicated malignancy with a sensitivity and specificity of 92% and a negative predictive value of 97%. In this tuberculosis-endemic area, technetium-99m methoxy isobutyl isonitrile single photon emission computed tomography evaluation of solitary pulmonary nodules had a high negative predictive value. Therefore, it has the potential to prevent unnecessary surgical resections of benign nodules and serve as a low-cost alternative when positron emission tomography is not available. Copyright©ERS Journals Ltd 2007.
dc.description.versionArticle
dc.identifier.citationEuropean Respiratory Journal
dc.identifier.citation30
dc.identifier.citation6
dc.identifier.issn09031936
dc.identifier.other10.1183/09031936.00046107
dc.identifier.urihttp://hdl.handle.net/10019.1/13762
dc.subjectfluorodeoxyglucose f 18
dc.subjectmethoxy isobutyl isonitrile technetium tc 99m
dc.subjectarticle
dc.subjectbronchoscopy
dc.subjectclinical article
dc.subjectcomputer assisted tomography
dc.subjectcontrolled study
dc.subjectdiagnostic procedure
dc.subjectdrug uptake
dc.subjectfollow up
dc.subjecthealth care planning
dc.subjecthealth care system
dc.subjecthuman
dc.subjectlung nodule
dc.subjectoutcome assessment
dc.subjectpatient assessment
dc.subjectphoton emission tomography
dc.subjectpositron emission tomography
dc.subjectpriority journal
dc.subjectsensitivity and specificity
dc.subjectsingle photon emission computer tomography
dc.subjectthorax radiography
dc.subjecttuberculosis
dc.subjectCoin Lesion, Pulmonary
dc.subjectEndemic Diseases
dc.subjectFemale
dc.subjectHumans
dc.subjectMale
dc.subjectMiddle Aged
dc.subjectRadiography, Thoracic
dc.subjectSouth Africa
dc.subjectTechnetium Tc 99m Sestamibi
dc.subjectTomography, Emission-Computed, Single-Photon
dc.subjectTreatment Outcome
dc.subjectTuberculosis
dc.titleSolitary pulmonary nodule evaluation with 99mTc-methoxy isobutyl isonitrile in a tuberculosis-endemic area
dc.typeArticle
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