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Quickly Predicting Chemotherapy Response to Paclitaxel-based Therapy in Non-Small Cell Lung Cancer by Early Technetium-99m Methoxyisobutylisonitrile Chest Single-Photon-Emission Computed Tomography¹

Department of Nuclear Medicine, Taichung Veterans General Hospital [C. H. K.]; Department of Nuclear Medicine, Chi-Mei Foundation Hospital [J. F. H.]; Department of Nuclear Medicine, Show-Chwan Hospital [S. C. T.]; Department of Radiology, Jen-Ai Hospital [Y. J. H.]; and Department of Nuclear Medicine, China Medical College Hospital [J. K. L.]; Taiwan

The purpose of this study was to retrospectively predict the chemotherapy response to paclitaxel in non-small cell lung cancer (NSCLC) using technetium-99m methoxyisobutylisonitrile (Tc-99m MIBI) chest single-photon-emission computed tomography (SPECT) to detect the expression of multidrug-resistance-mediated M_r 170,000 P-glycoprotein. Before chemotherapy with Paclitaxel (Taxol), 30 patients with stage IIIb or IV NSCLC were enrolled in this study. Early chest SPECT 10 min after i.v. injection of Tc-99m MIBI was performed to qualitatively interpret Tc-99m MIBI chest SPECT visually and quantitatively calculate early tumor:normal lung ratios (T:NL) for quick assessment of multidrug-resistant P-glycoprotein expression in NSCLC. On the basis of qualitatively visual interpretation of early Tc-99m MIBI chest SPECT, all of 15 (100%) cases with good response to chemotherapy with Taxol could be detected but 10 (67%) of 15 cases with poor response could not be detected. Early Tc-99m MIBI chest SPECT could correctly predict chemotherapy response in 25 (83%) of 30 of cases. The early T:NL were 3.30 ± 0.82 for 15 patients with good response and 2.02 ± 0.19 for 5 patients with poor response. The differences were significant (P < 0.05) by independent Student t tests. However, no significant differences were found for other prognostic factors (age, sex, tumor size, tumor location, stage, and cell type) between good-response and poor-response patients. Early Tc-99m MIBI chest SPECT has the potential to predict chemotherapy response to Paclitaxel.

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