Abstract
Introduction. Algorithms of the early detection of lung cancer remain a topic of discussion and the problem of timely assessment of the expansion of lung cancer remains unresolved.Objective – to determine if the combined use of contrastenhanced MDCT and 99mTcMAA SPECT and Gallium‐67 citrate SPECT is effective in assessing the expansion of lung cancer in the determination in the intervention tactics.Material and methods. In the study, radiologic examination was performed to 81 patients with lung cancer. Combined examinations included bolus contrastenhanced computed tomography (n = 81 patients), 99mTcMAA SPECT (n = 62 patients) and Gallium‐67 citrate SPECT (n = 9 patients).Results.According to MDCT data in most cases (n = 65 patients; 80 %) this method was able to diagnose the Tstage of the tumor; in some cases, the stage of malignancy was overestimated (n = 8 patients, 10 %), or underestimated (n = 8 patients, 10 %). According to the results of 99mТcМАА SPECT, it was possible to reliably determine the microcirculation disorders that were observed in the whole group of patients, while in 12 cases the impaired blood flow was recorded only according to the results of 99mTcMAA SPECT and in 50 cases the severity of changes in blood flow was more signifcant than according to MDCT. When analyzing Ga67 citrate SPECT data, in all 9 cases wholebody Ga67 citrate SPECT showed intense hot areas at the tumor region. It was also possible to show several mildly increased foci in the hilar lymph nodes in 6 cases, but in 3 cases the result was false positive.Conclusions. Bolus contrastenhanced computed tomography in most cases allows to correctly determine the Tstage of lung cancer and show tumor invasion into the surrounding tissues and vessels. At the same time, an additional 99mTcMAA SPECT study allows to clarify the degree of disturbance of the microvasculature in more detail. It is possible to supplement the assessment of regional metastasis by Gallium‐67 citrate SPECT, however, it is necessary to take into account the inflammatory nature of lymph node changes as a cause of falsepositive data.
Highlights
Развитие радионуклидной диагностики дало но вые возможности изучения метаболических процес сов на клеточном и молекулярном уровне с помощью ПЭТ и однофотонной эмисионной компьютерной томографии (ОФЭКТ) [9,10,11,12,13]
Выполнение однофотонной эмисионной компьютерной томографии (ОФЭКТ) с 99m-Tc-МАА позволяет оценить функциональное состояние лег ких, степень изменения микроциркуляторного русла и определить его вовлечение в онкологический про цесс, а исследование с цитратом Ga-67 – провести
Summary
Заболеваемость раком легкого сохраняет лидиру ющие позиции в России, несмотря на современные достижения в диагностике этого заболевания, прово димые меры профилактики и раннего выявления. Анализ стати стики говорит о том, что в Российской Федерации за последние 10 лет частота встречаемости рака легкого выросла у мужчин на 0,5 %, а у женщин – на 25,3 % [4].
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