Diagnostic Value of Semiquantitative Analysis of (99m)Technetium-Methoxyisobutylisonitrile ((99m)Tc-MIBI Imaging in Predicting Early-Stage Cervical Lymph Node Metastasis of Thyroid Carcinoma

BACKGROUND: The aim of this study was to evaluate the value of semiquantitative analysis (SQA) of (99m)Tc-MIBI imaging in predicting early-stage cervical lymph node metastasis (CLNM) in thyroid carcinoma (TC). MATERIAL/METHODS: TC patients (n=106) undergoing surgical resection and histopathological examination were enrolled. All patients received (99m)Tc-MIBI imaging prior to surgery. P-glycoprotein (P-gp) expression was detected by PT-PCR and immunohistochemistry. With pathological results as the criterion standard, the diagnostic efficiency of (99m)Tc-MIBI imaging in predicting early-stage CLNM was evaluated. The correlation of P-gp with (99m)Tc-MIBI imaging was investigated. Logistic regression analysis was applied for analyzing the factors affecting early-stage CLNM. RESULTS: The detection rate and misdiagnosis rate of (99m)Tc-MIBI imaging for early-stage CLNM diagnosis were 87.3% and 12.7%, respectively. Receiver operating characteristic (ROC) curve analysis showed an accuracy of (99m)Tc-MIBI imaging of 85.85%. Preoperative (99m)Tc-MIBI scan showed statistical differences between metastasis and non-metastasis groups in early and delayed T/NT and washout rate (all P<0.05). The percentage of P-gp-expressing cells and the expression rate of P-gp gene both exhibited statistical differences between metastasis and no-metastasis groups (both P<0.05). Tumor diameter, lesion distribution, the percentage of P-gp-expressing cells, and the expression rate of P-gp gene were risk factors for CLNM (all P<0.05). CONCLUSIONS: (99m)Tc-MIBI imaging has value in qualitative diagnosis of early-stage CLNM in TC. Tumor diameter, lesion distribution, the percentage of P-gp-expressing cells, and the expression rate of P-gp gene were risk factors for CLNM.