C. Soler et al., Technetium-99m sestamibi brain single-photon emission tomography for detection of recurrent gliomas after radiation therapy, EUR J NUCL, 25(12), 1998, pp. 1649-1657
Citations number
35
Categorie Soggetti
Radiology ,Nuclear Medicine & Imaging","Medical Research Diagnosis & Treatment
Technetium-99m sestamibi (MIBI), an alternative radiopharmaceutical for myo
cardial perfusion imaging, has also been proposed for use as an imaging age
nt for various tumours, including breast cancer, lung cancer, lymphomas, me
lanomas and brain rumours. After routine radiation therapy, deteriorating c
linical status or treatment failure may be due to either radiation-induced
changes or recurrent tumour. Computed tomography and magnetic resonance ima
ging offer imperfect discrimination of tumour viability and radionecrosis.
Against this background we undertook a retrospective study of 35 malignant
glioma patients in whom clinical deterioration had occurred, in order to cl
arify the value of Tc-99m-MIBI SPET in identifying tumour recurrence. SPET
was performed 15 min after intravenous injection of 1110 MBq Tc-99m-MIBI. T
he images were obtained with a dual-headed gamma camera using a fan-beam co
llimator. Transverse, coronal and sagittal views were reconstructed. Intens
e MIBI uptake was found in 31 patients. This uptake was correlated with tum
our recurrence as proved by histology and/or rapid, fatal evolution of thes
e cases. The statistical analysis performed on this population of patients
with MIBI uptake revealed a group of patients with a long mean survival and
a group with a short mean survival. Two subgroups were found within each o
f these groups, according to the functional index ratio (tumour uptake/pitu
itary gland uptake ratio). No MIBI uptake was found in four patients who ar
e still alive and can be considered to be disease-free. In those cases show
ing MIBI uptake, death occurred an average of 6.69 months following brain S
PET. According to our results, the specificity and sensitivity of Tc-99m-MI
BI brain SPET seem to be high. Moreover, this technique is more accurate th
an computed tomography or magnetic resonance imaging for discriminating bet
ween tumour recurrence and radionecrosis.