Medical Radiology and Radiation Safety. 2025. Vol. 70. № 6
DOI:10.33266/1024-6177-2025-70-6-121-128
S.M. Minin1, Zh.Zh. Anashbaev1, N.V. Novikova1, E.A. Samoilova1,
S.I. Sazonova2, N.V. Salin2, S.M. Korobeinikov3, Yu.B. Lishmanov4,
W.Yu. Ussov1, A.M. Chernyavsky1
The Possibilities of Employing Spect/Ct with 99mtc-MIBI in the Screening of Tumors of the Chest (Lung Cancer, Breast Cancer)
in Patients with Pathology of the Cardiovascular System
1 E.N. Meshalkin National Research Medical Center, Novosibirsk, Russia
2 Scientific Research Institute of Cardiology, Tomsk, Russia
3 Novosibirsk State Technical University, Novosibirsk, Russia
4 National Research Tomsk Polytechnic University, Tomsk, Russia
Contact person: Wladimir Yuryevich Ussov, e-mail: This email address is being protected from spambots. You need JavaScript enabled to view it. , This email address is being protected from spambots. You need JavaScript enabled to view it.
Summary
Background: It is assumed that with the screening use of SPECT/CT with 99mTc-MIBI in patients with suspected coronary heart disease, this study may also reveal concomitant cancer at the preclinical pre-metastatic stage in patients who have developed lung cancer or breast cancer, so far only at an asymptomatic stage.
Purpose: To evaluate the possibilities of SPECT/CT with 99mTc-MIBI as a screening method for the diagnosis of lung cancer and breast cancer in the mass examination of patients aged 42‒75 years for coronary artery disease.
Material and methods: The study comprised 1127 patients (796 men and 331 women), aged 39‒80 years, who were studied on an outpatient basis in the Department of Radionuclide Therapy and Diagnostics of the NMIC in the period from April 2022 to October 2024. Аn SPECT/CT examination of the myocardium with 99mTc-MIBI was performed during the diagnosis of coronary heart disease, which completely included the chest area, from the lower neck to the top of the abdominal cavity. Patients who, due to the main focus on the detection of coronary heart disease, did not cover the entire chest area were not included in the study. The SPECT was performed in a 64×64 matrix with 180° rotation of the gamma camera detector, 32‒64 projections, and a rotation radius of 35‒40 cm, with a set of at least 50,000 impulses per each. Up to 50 transverse tomographic sections of the heart and chest were reconstructed, taking into account the tissue absorption of 0.12 cm‒1. A visual analysis was performed for the presence of nodular pathology in the lungs with a uptake of 99mTc-MIBI. The tumor blood flow (РКрОп, ml) were calculated as РКрОп = СПНTc-MIBI × (МО / ВbodyWeightof Patient) × 100, where СПН Tc-MIBI is the standardized uptake value of the radiopharmaceutical, and MO is the minute volume of cardiac output, in ml/min, and 100 is the conversion factor for representing the result in the usual units of ml/min/100 g of tissue. According to the uptake of 99mTc-MIBI in the organs and systems of the patient, the radiation dose for SPECT was calculated using the technique and the MIRD software, as well as the radiation ldose provided by X-ray CT of the examined area, in contrast-free mode and with additional intravenous contrast enhancement.
Results: When using SPECT/CT with 99mTc-MIBI for the diagnosis of coronary heart disease, confirmation of the referral diagnosis was obtained as a transient defect of myocardial perfusion in 23 % of the examined patients, and in 7 % as a persistent defect in perfusion. Along with coronary heart disease, 9 patients (8 men, 1 woman) were diagnosed with clinically asymptomatic lung cancer (6 had central lung cancer, 3 had peripheral one) as a nodular formation with pathological absorption of this radiopharmaceutical. 6 patients with lung cancer had relatively low blood flow in the primary tumor node, 14‒25 ml/min/100 g of tissue (on average, 19.5 ± 3.5 ml/min/100 g of tissue). The stage of the disease was as follows: T1N0M0 – in 2, T2N0M0 – in 2, T3N1M0 – in 1, T2N1M1 – in 1. In three out of nine patients with lung cancer, blood flow in the primary node was significantly higher, ranging from 27‒43 ml/min/100 g of tissue (on average, 34.5 ± 6.2 ml/min/100 g of tissue). Their stages of the disease were T2N1M0 – 2 patients, T3N2M1 – 1 patient, which corresponded to the wellknown relationship “high blood flow in the primary tumor ‒ higher probability of metastasis”. Of the women examined, two had clinically asymptomatic breast cancer, T2N0M0 and T1N1M0, which was first detected during this SPECT/CT.
Conclusions: It is reasonable to believe that SPECT/CT of the heart and chest with 99mTc-MIBI can act not only as a highly sensitive marker of myocardial blood flow, providing outpatient diagnosis of coronary heart disease, but also for screening detection of tumor pathology of the chest organs, due to the oncotropy of this radiopharmaceutical, while minimizing radiation exposure to the patient.
Keywords: SPECT/CT, 99mTc-MIBI, coronary heart disease, screening, lung cancer
For citation: Minin SM, Anashbaev ZhZh, Novikova NV, Samoilova EA, Sazonova SI, Salin NV, Korobeinikov SM, Lishmanov YuB, Ussov WYu, Chernyavsky AM. The Possibilities of Employing Spect/Ct with 99mtc-MIBI in the Screening of Tumors of the Chest (Lung Cancer, Breast Cancer) in Patients with Pathology of the Cardiovascular System. Medical Radiology and Radiation Safety. 2025;70(6):121–128. (In Russian). DOI:10.33266/1024-6177-2025-70-6-121-128
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Conflict of interest. The authors declare no conflict of interest.
Financing. The study was carried out as part of State Assignment No. 123030900018-1 of the Russian Ministry of Health.
Contribution. Article was prepared with equal participation of the authors.
Article received: 20.07.2025. Accepted for publication: 25.08.2025.