[Evaluation of bone and soft tissue lesion using 99mTc-MIBI: comparison with 201Tl and the relation to...

Thirty-five patients with bone and soft tissue lesions were studied with 99mTc-MIBI and 201Tl to compare the uptake of two tracers. Planar images were obtained 15 min (early image) and 3 hr (delayed image) after the injection of both tracers. Images were evaluated visually and quantitatively using uptake ratio (lesion/background). In visual analysis, 23 of 35 patients showed similar uptake of both tracers, 9 showed more intense uptake of 99mTc-MIBI than 201Tl, and 3 showed more intense uptake of 201Tl than 99mTc-MIBI on early images. On delayed images, 21 of 32 patients showed similar uptake of both tracers, 3 showed more intense uptake of 99mTc-MIBI than 201Tl, and 8 showed more intense uptake of 201Tl than 99mTc-MIBI. In quantitative analysis, similar 201Tl and 99mTc-MIBI uptake ratios were obtained on early images. On delayed images, 99mTc-MIBI uptake ratios are less than that of 201Tl, but the difference was not significant. In some cases, 99mTc-MIBI accumulation was washed out on delayed images, therefore the early image is essential to evaluate 99mTc-MIBI accumulation. In all cases with the uptake ratios less than 1.20 on delayed 99mTc-MIBI images, chemotherapy was not effective. In malignant tumors, decreased uptake of 99mTc-MIBI accumulation on delayed images may indicate that chemotherapy is not effective. Delayed 99mTc-MIBI image may be a potential marker predicting chemotherapeutic effect in malignant bone and soft tissue tumors.