Diagnostic Value of Semiquantitative Analysis of (99m)Technetium-Methoxyisobutylisonitrile (Tc-99m-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 Tc-99m-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 Tc-99m-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 Tc-99m-MIBI imaging in predicting early-stage CLNM was evaluated. The correlation of P-gp with Tc-99m-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 99mTc-MIBI imaging for early-stage CLNM diagnosis were 87.3% and 12.7%, respectively. Receiver operating characteristic (ROC) curve analysis showed an accuracy of Tc-99m-MIBI imaging of 85.85%. Preoperative Tc-99m-MIBI scan showed statistical differences between metastasis and nonmetastasis 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 nometastasis 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: Tc-99m-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.