| Objective:99m-Methoxyisobutylisonitrile (SPECT-99mTc-MIBI) affinity tumor imaging is a nuclear medicine imaging method commonly used for tumor diagnosis and it is a kind of functional imaging. The nature is identified according to the metabolic characteristics of lesions with relatively higher sensitivity. However the specificity is not high. The topic tends to compare the differences of images obtained from SPECT-99mTc-MIBI affinity tumor imaging of lungs before and after oxygen uptake through patients’absorbing oxygen using masks and discuss the application value of oxygen intervention in SPECT-99mTc-MIBI affinity tumor imaging to identify SPN.Methods:Lung SPECT-99mTc-MIBI affinity tumor imaging is carried out for undefined SPN patients in 45 CT tests. Patients are asked to take the imaging again after oxygen uptake. Areas interested are drawn using semi-quantity analysis. Count ratios of early phase radioactivity and late phase radioactivity (ER,DR) of the contralateral normal lung tissue and this area are calculated. The sensitivity, specificity and accuracy of two imaging are calculated respectively. The differences of ER and DR values and sensitivity, specificity and accuracy of two imaging are compared.Results:1. There are 34 malignant cases and 11 benign cases in 45 patients, among which, there are 16 cases of glandular cancer,14 cases of squamous carcinoma,4cases of adenosquamous carcinoma,3 cases of tuberculosis,6 cases of inflammatory change and 2 case of hamartoma.2. The ER averages of the malignant group and benign group before oxygen uptake are 2.02±0.26 (95%CI:1.93～2.11) and 1.64±0.16 (95%CI:1.54-1.75). There are significant differences between these two (t=5.80, P<0.05). The DR averages of the malignant group and benign group before oxygen uptake are 2.21±0.27 (95%CI:2.11～2.30) and 1.69±0.16 (95%CI:1.58～1.80). There are significant differences between these two (t=6.03, P<0.05).3. The ER averages of the malignant group and benign group after oxygen uptake are 2.51±0.32 (95%CI:2.40-2.62) and 1.69±0.17 (95%CI:1.58～1.81). There are significant differences between these two (t=10.87, P<0.01). The DR averages of the malignant group and benign group before oxygen uptake are 2.81±0.35 (95%CI: 2.69～2.93) and 1.74±0.16 (95%CI:1.63～1.85). There are significant differences between these two (t=13.78, P<0.01).4. The ER averages of the malignant group after oxygen uptake increase significantly compared with those before oxygen uptake:2.51±0.32 (95%CI:2.40～ 2.62) VS 2.02±0.26 (95%CI:1.93-2.11) (F=48.23, P<0.01). The DR averages increase significantly compared with those before oxygen uptake as well:2.81±0.35 (95%CI:2.69-2.93) VS 2.21±0.27(95%CI:2.11-2.30) (F=63.78, P<0.01).There are no significant changes in the ER averages and DR averages of the benign group before and after oxygen uptake (ER:F=0.56, P=0.47; DR:F=0.58, P=0.45).5.There are no significant differences among the ER or DR averages of each subgroups of the malignant group before oxygen uptake (ER:F=0.59, P=0.56; DR: F=0.40,P=0.67). There no significant differences among the ER or DR averages of each subgroups of the malignant group after oxygen uptake as well (ER:F=1.35, P=0.27; DR:F=3.02, P=0.06).6.The sensitivity, specificity and accuracy of SPECT-99mTc-MIBI lung carcinoma imaging to identify the SPN are 82.4%、63.6%、77.7% before oxygen uptake and 94.1%、90.9%、93.3% respectively after oxygen uptake. The accuracy of SPECT-99mTc-MIBI lung carcinoma imaging to identify the SPN increased significantly (χ2=5.14, P<0.05) after oxygen uptake, although the sensitivity and specificity increased as well, but not significantly (P>0.05).Conclusions:1.99mTc-MIBI could be concentrated differently in lung malignant lesions. Although benign lesions such as inflammation etc. could also absorb 99mTc-MIBI, the absorbing ability is obviously lower than that of malignant lesions.2. Oxygen uptake could improve the anaerobic conditions of lung tumor tissues, and increase the uptake ratio of 99mTc-MIBI by lung malignant lesions, but it has no significant influence on the 99mTc-MIBI absorbing ability of benign lesions, so the difference of the ability to uptake 99mTc-MIBI between malignant lesions and benign lesions becomes more obvious, which makes the malignant lesions more striking.3. There are no significant differences of 99mTc-MIBI absorbing abilities between glandular cancer, squamous carcinoma and adenosquamous carcinoma. There is no significant difference in the influence of oxygen uptake on different types of lung cancer.4. Oxygen uptake could effectively increase the accuracy of SPECT-99mTc-MIBI lung carcinoma imaging to identify the SPN, reduce the rate of missed diagnosis and misdiagnosis. |
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