4.6 Article

Thallium-201 Scintigraphy Is an Effective Diagnostic Modality to Distinguish Malignant From Benign Soft-Tissue Tumors

Journal

CLINICAL NUCLEAR MEDICINE
Volume 36, Issue 11, Pages 982-986

Publisher

LIPPINCOTT WILLIAMS & WILKINS
DOI: 10.1097/RLU.0b013e3182177407

Keywords

thallium-201; scintigraphy; soft-tissue; tumor; sarcoma

Funding

  1. Ministry of Education, Culture, Sports, Science and Technology [20591781]
  2. Ministry of Health, Labor and Welfare [14S-4, 14S-5]
  3. Grants-in-Aid for Scientific Research [20591781] Funding Source: KAKEN

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Background: The aim of this study is to evaluate whether thallium-201 (201-Tl) scintigraphy can differentiate malignant from benign soft-tissue tumors. Methods: Between April 1995 and December 2005, 192 patients with soft-tissue tumors (85 malignant and 107 benign) underwent 201-Tl scintigraphy before treatment. Isotope uptake was used as a proxy for tumor-to-background ratio (TBR). The accuracy of TBR on early and delayed imaging was evaluated using the Mann-Whitney U and chi(2) tests. Results: There was a statistically significant difference in mean TBR on early and delayed imaging of malignant and benign soft-tissue tumors (124% +/- 109% vs. 22% +/- 42%, and 82% +/- 83% vs. 12% +/- 25%, P < 0.0001). A TBR cutoff of 20% indicated the probability of malignancy on early and delayed imaging (82% sensitivity and 77% specificity; 82% sensitivity and 84% specificity, P < 0.0001). Well-differentiated liposarcomas showed low isotope accumulation, while pigmented villonodular synovitis and giant cell tumors of the tendon sheath showed high isotope accumulation. Conclusions: Thallium-201 scintigraphy can distinguish malignant from benign tumors with relatively high accuracy. With the exception of low grade liposarcomas and locally aggressive benign tumors, 201-Tl scintigraphy may be an effective diagnostic modality to differentiate malignant from benign soft-tissue tumors.

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