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The journal «ONCOSURGERY» 2013, Vol.5, No 3

Scintigraphy with 199Tl-chloride in differential diagnosis of malignant and benign lesions

Choinzonov ЕL1,2, Kurazhov АP2, Zavadovskaya VD2, Zorkaltsev МА2, Slonimskaya ЕМ1,2, Tjukalov JuI1

1) Cancer Research Institute, Siberian Branch of the Russian Academy of Medical Sciences,
2) Siberian State Medical University,
Tomsk, Russia
Contact: Kurazhov Aleksey Petrovich, e-mail:

The results of new technique improving differential diagnosis of tumors and inflammatory lesions by scintigraphy with 199Tl-chloride, which is more available and has less radiation exposure comparing with foreign analogue 201Tl-chloride, are represented.

The objective: to develop the method of differentiation for malignant and benign lesions using scintigraphy with 199Tl-chloride.

Material and methods. The results of scintigraphy in 97 patients with 119 foci of 199Tl-сhloride hyperfixation in malignant tumors (n=68) and benign lesions (n=51), localized in musculoskeletal system (n=89), lungs and mediastinal organs (n=25) and other organs (n=5) are described.

Results. Retention index (RI) in malignant tumor group (RI=0.97±0.17) was significantly higher (p<0.001) than those for benign lesions group (RI=0.74±0.12). For evaluated with ROC-analysis the best value of constant independent retention index RI=0.89, the sensitivity, specificity and accuracy of scintigraphy with 199Tl-chloride for malignant tumor diagnosis were 75.0%, 86.3% and 84.0%, respectively.

To improve differential capability of scintigraphy with 199Tl-chloride the pharmacokinetics of this indicator in foci of malignant and benign lesions was studied. The significant correlations of RI with value of hyperfixation in early phase of scintigraphy (ER) both in the group of malignant tumors (r=-0.70, n=68, p<.001) and in the group of benign lesions (r=-0.76, n=51, p<.001) were determined. The method for differentiation malignant and benign lesions during scintigraphy with 199Tl-chloride based on ER and RI was introduced. For differential diagnosis by value relative retention index dependent on ER (RI(relative)) RI(relative)=RI+0,055•ER for cut-off value RI (relative)=0,98 the sensitivity, specificity and accuracy of diagnostics for malignant tumor accounted for 83.8%, 86.3% and 85.5%, respectively.

Conclusions. Relative retention index significantly improves the efficiency of scintigraphy with 199Tl-chloride for differential diagnosis of malignant and benign lesions comparing with conventionally used constant retention index (p=0.01).

KEY WORDS: scintigraphy with 199Tl-chloride, malignant tumor, benign lesion, retention index.


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