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Journal of Neuro-Oncology

, Volume 77, Issue 2, pp 177–183 | Cite as

Sestamibi technetium-99m brain single-photon emission computed tomography to identify recurrent glioma in adults: 201 studies

  • Florence Prigent –Le JeuneEmail author
  • François Dubois
  • Serge Blond
  • Marc Steinling
Clinical-Patient Studies

Summary

Object

In the follow-up of treated gliomas, CT and MRI can often not differentiate radionecrosis from recurrent tumor. The aim of this study was to assess the interest of functional imaging with 99mTc-MIBI SPECT in a large series of 201 examinations.

Method

MIBI SPECT were performed in 81 patients treated for brain gliomas. A MIBI uptake index was computed as the ratio of counts in the lesion to counts in the controlateral region. SPECT was compared to stereotactic biopsy in 14 cases, or in the others cases to imaging evolution or clinical course at 6 months after the last tomoscintigraphy

Two hundred and one tomoscintigraphies were performed. One hundred and two scans were true positive, 82 scans were true negative. Six scans were false positive (corresponding to 3 patients): 2 patients with an inflammatory reaction after radiosurgery, 1 with no explanation up to now. Eleven scans were false negative (5 patients): 1 patient with a deep peri-ventricular lesion, 2 patients with no contrast enhancement on MRI, 2 patients with a temporal tumor. The sensitivity for tumor recurrence was 90%, specificity 91.5% and accuracy 90.5%. We studied separately low and high grade glioma: sensitivity for tumor recurrence was respectively 91% and 89%, specificity 100% and 83% and accuracy 95% and 87%. MIBI SPECT allowed the diagnose of anaplasic degenerence of low grade sometimes earlier than clinical (5 cases) or MRI signs (7 cases).

Conclusions

Our results confirm the usefullness of MIBI SPECT in the follow-up of treated gliomas for the differential diagnosis between radiation necrosis and tumor recurrence.

Keywords

brain SPECT MIBI radiation necrosis tumor recurrence 

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Notes

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Copyright information

© Springer 2005

Authors and Affiliations

  • Florence Prigent –Le Jeune
    • 1
    Email author
  • François Dubois
    • 2
  • Serge Blond
    • 2
  • Marc Steinling
    • 1
  1. 1.Service de Médecine NucléaireUnité fonctionnelle de neurologie, Hôpital Roger SalengroChru de LilleFrance
  2. 2.Service de NeurochirurgieHôpital Roger SalengroChru de LilleFrance

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