Sestamibi technetium-99m brain single-photon emission computed tomography to identify recurrent glioma in adults: 201 studies
- 165 Downloads
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.
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).
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.
Keywordsbrain SPECT MIBI radiation necrosis tumor recurrence
Unable to display preview. Download preview PDF.
- 6.Bedar JB, Samnick S, Moringlane JR, Feiden W, Schaefer A, Kremp S, Kirsch CM, Evaluation of L-3-[123I]iodo-α-methyltyrosine SPET and [18F]fluorodeoxyglucose PET in the detection and grading of recurrences in patients pretreated for gliomas at follow-up: a comparative study with stereotactic biopsy Eur J Nucl Med 26: 144–151, 1999CrossRefGoogle Scholar
- 9.Di Chiro G, Oldfield E, Wright D, Katz DA, PET, CT and NMR of cerebral necrosis following radiotherapy or intra-arterial chemotherapy for cerebral tumors AJNR 6:473–474. 1985Google Scholar
- 10.Di Chiro G, Oldfield E, Wright D, De Michele D, Katz D, Patronas N, Doppman J, et al.: Cerebral necrosis after radiotherapy and/or intra-arterial chemotherapyGoogle Scholar
- 13.Derlon JM, Petit-Taboue MC, Chapon F, Beaudouin V, Noël MH, Creveuil C, Courtheoux P, et al. The in vivo-metabolic pattern of low-grade brain gliomas: a positron emission tomographic study using 18 F-fluorodeoxyglucose and 11 C-L-methylmethionine Neurosurgery 40:276–288, 1997PubMedCrossRefGoogle Scholar
- 23.Lamy-Lhuillier C, Dubois F, Blond S, Lecouffe P, Steinling M Intérêt de la tomoscintigraphie cérébrale au sestamibi marqué au technétium dans le diagnostic différentiel récidive tumorale-radionécrose des tumeurs gliales sus-tentorielles de l’adulte. Neurochirurgie 45:110–117, 1999Google Scholar
- 28.Borodin OYU, Velichko OB, Garganeev AB, Riannel JU, Barisheva EV, Krivonogov NG, Ussov W.: Comparaison of 99 mTc-MIBI SPECT and GD-enhanced MRI in detection of recurrent tumor in malignant gliomas. EANM Congress Paris 2000. Eur J Nucl Med 2000Google Scholar
- 29.Ambrus E, Pavics L, Grünwald F, Barath B, Tiszlavicz L, Bender H, Menzel C, et al. 99 mTc-MIBI-SPECT-studies in the evaluation of brain tumors Radiologia diagnostica 35:299–302, 1994Google Scholar
- 39.Kostakaglu L, Elahi N, Kïratli P, Clinical validation of the influence of P-glycoprotein on technetium-99 m-sestamibi uptake in malignant tumors J Nucl Med 38: 1003–1008, 1997Google Scholar