Medical Radiology and Radiation Safety. 2020. Vol. 65. No. 1. P.27–36

A.S. Krylov1, A.D. Ryzhkov1, S.V. Shiryaev1, M.O. Goncharov1, M.A. Krylova2, D.A. Komanovskaya1, M.E. Bilik1, S.M. Kaspshik1, E.M. Mikhailova1, E.E. Stanyakina1, A.G. Zhukov3

The Value of 99mTc-MIBI SPECT/CT Imaging in Evaluation of Head and Neck Cancer in Children

1. N.N. Blokhin National Medical Research Center, Moscow, Russia. E-mail: Этот адрес электронной почты защищен от спам-ботов. У вас должен быть включен JavaScript для просмотра.
2. Children’s City Polyclinic No. 11 of the Moscow City Health Department, Moscow, Russia
3. Clinical Hospital No. 52 Department of health of Moscow, Moscow, Russia


Introduction: Head and neck cancers is a group of cancers that can vary in their histological form and localization. This disease has a high social significance thus it require well-timed and delicate approach, especially in children. We can improve the accuracy of diagnostic methods by using new algorithms and technologies. In this article we reveal the first experience of implementing 99mTc-MIBI SPECT/CT imaging for evaluation of head and neck cancer in children and introduce it as a routine method in Russia.

Purpose: Improve the diagnostic accuracy of head and neck cancer imagining in children by practical application of hybrid SPECT/CT method. Determine diagnostic value of planar scintigraphy and 99mTc-MIBI SPECT/CT of head and neck cancer in children.

Material and methods: This study was performed as a prospective clinical study. Between January 2017 and December 2017, 53 patients which met the inclusion criteria were examined. The inclusion criteria were patients with histologically proven malignancy, age 1–18, weight more than 10 kg, up to date CT or MRI scans (less than two weeks passed from scanning), for initial patients a tumor findings (more than 20 mm in the largest scale). We concluded 61 whole body planar scintigraphy followed by head and neck 99mTc-MIBI SPECT/CT examinations. 10 patients were examined twice, 1 patient was undergoing for this procedure for three times. Initial patients – 23, dynamic – 30. We performed scanning using a hybrid SPECT/CT after 15 minutes 99mTc-MIBI was injected. First stage was standard whole-body planar scintigraphy, second stage SPECT/CT (head and neck).

Results: We evaluated diagnostic accuracy of planar scintigraphy and 99mTc-MIBI SPECT/CT.
Planar scintigraphy sensitivity, specificity, NPV and PPV were 68.8, 96.6, 73.7, 95.7 %. SPECT/CT – 87.5, 96.6, 87.5, 96.6 %.
The verification method was histological examination or follow-up imagining (CT or MRI) during a 12 month period. Additional imagining using hybrid SPECT/CT method allows us to increase sensitivity and NPV of isotope scanning.
Most of false-negative results were obtained after planar scintigraphy, it can be related with image interpretation difficulties caused by equivocal image, especially, in patients during therapy. Six of such patients were correctly diagnosed with SPECT/CT and we revealed the presence of active tumor tissue.
With CT we additionally detected destruction of skull bones in 10 patients.

Conclusion: 1. Diagnostic accuracy of scintigraphy with 99mTc-MIBI is high: Sens. – 68.8 %. 2. We can increase diagnostic accuracy using hybrid methods, and so it plays an important role in final diagnosis: Sens. – 87.5 %, Spec. – 96.6 %. 3. SPECT/CT additionally detected destruction of skull bones even with negative scintigraphy results. 4. A strict clinical reasoning is needed in each individual case. 5. A further evaluation of the diagnostic capabilities of 99mTc-MIBI SPECT/CT in a larger number of patients appears justified.

Key words: SPECT/CT, 99mTc-MIBI, neck and head cancer, oncopediatry

For citation: Krylov AS, Ryzhkov AD, Shiryaev SV, Goncharov MO, Krylova MA, Komanovskaya DA, Bilik ME, Kaspshik SM, Mikhailova EM, Stanyakina EE, Zhukov AG. The Value of 99mTc-MIBI SPECT/CT Imaging in Evaluation of Head and Neck Cancer in Children. Medical Radiology and Radiation Safety. 2020;65(1):27-36. (In Russ.).

DOI: 10.12737/1024-6177-2020-65-1-27-36

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PDF (RUS) Full-text article (in Russian)

Conflict of interest. The authors declare no conflict of interest.

Financing. The study had no sponsorship.

Contribution. Article was prepared with equal participation of the authors.

Informed consent. Parents of patients signed an informed consent for their children to participate in the study.

Article received: 30.10.2019. Accepted for publication: 11.12.2019