Evaluation of brain tumor recurrence by 99mTc-tetrofosmin SPECT: a prospective pilot study

Alexiou, George Α.; Fotopoulos, Andreas; Παπαδόπουλος, Αθανάσιος; Kyritsis, Athanasios P.; Polyzoidis, Konstantinos S.; Tsiouris, Spyridon

doi:10.1007/s12149-007-0027-x

Cited by 53 publications

(31 citation statements)

References 22 publications

(22 reference statements)

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“…In both tumor types we verified a strong positive linear correlation between tracer uptake and tumor proliferative potential and aggressiveness [4][5][6]. Furthermore, we reported that 99m Tc-TF SPECT could hold a role in differentiating tumor recurrence from radiation necrosis and neoplastic from non-neoplastic intracerebral hemorrhage [7,8]. We therefore propose 99m Tc-TF SPECT as a cost-effective functional imaging modality that offers a noninvasive method for quantitating cellular proliferation in gliomas thus assisting therapeutic decision-making and prognosis estimation.…”

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confidence: 69%

99mTc-Tetrofosmin SPECT for Glioma Evaluation

et al. 2009

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supporting

confidence: 69%

99mTc-Tetrofosmin SPECT for Glioma Evaluation

et al. 2009

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“…99m Tc-sestamibi has been extensively used and proved useful for metabolic characterization (16). 99m Tc-tetrofosmin is a lipophilic diphosphine that has also proven suitable for brain tumor imaging (10,11,(17)(18)(19). Its uptake in the healthy brain is physiologically seen in the choroid plexus and the pituitary gland but not in the normal brain parenchyma, because it does not cross the intact blood-brain barrier.…”

Section: Discussionmentioning

confidence: 99%

“…We have recently shown in vivo that, in contrast to 99m Tc-sestamibi, 99m Tc-tetrofosmin is not influenced by the multidrug-resistance phenotype of gliomas and may thus be superior for brain tumor imaging (18). Furthermore, 99m Tc-tetrofosmin can be a suitable radiotracer for the differentiation of glioma recurrence from radiation necrosis, neoplastic from nonneoplastic intracerebral hemorrhage, and benign from malignant brain space-occupying lesions and for the assessment of the proliferation potential of gliomas and meningiomas (19)(20)(21).…”

Section: Discussionmentioning

confidence: 99%

The Value of ^99mTc-Tetrofosmin Brain SPECT in Predicting Survival in Patients with Glioblastoma Multiforme

Alexiou¹,

Tsiouris²,

Kyritsis³

et al. 2010

J Nucl Med

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99m Tc-tetrofosmin brain SPECT has been reported as a useful tool for the evaluation of glioma proliferation. In the present study, we set out to investigate the prognostic value of 99m Tctetrofosmin brain SPECT in patients with glioblastoma multiforme. Methods: We prospectively studied 18 patients (13 men, 5 women; mean age 6 SD, 60.8 6 7.79 y) who were operated on for glioblastoma multiforme. All patients underwent preoperative 99m Tc-tetrofosmin brain SPECT, and surgical excision was performed within a week after SPECT. All patients received postoperative radiotherapy and chemotherapy. Results: By calculating the lesion-to-normal (L/N) 99m Tc-tetrofosmin uptake ratio, we found that patients with an L/N ratio of more than 4.7 had significantly worse survival than did patients with an L/N ratio of 4.7 or less. Furthermore, patients with a Karnofsky Performance Score more than 90 had a significantly better survival rate. Although patients with near-total tumor resection who were younger than 60 y survived longer, the difference did not reach statistical significance. In the multivariate analysis, 99m Tc-tetrofosmin uptake and Karnofsky Performance Score were identified as factors with independent prognostic power. Conclusion: 99m Tc-tetrofosmin brain SPECT may be an independent prognostic factor in patients with glioblastoma multiforme. Further larger studies are needed to verify these results.Key Words: 99m Tc-tetrofosmin; brain SPECT; glioblastoma multiforme; survival Nucl Med 2010; 51:1923 51: -1926 51: DOI: 10.2967 Gl ioblastoma multiforme (GBM) is by far the most common and most malignant of the glial tumors occurring in adults. This devastating disease is usually incurable, and patients have a median survival time of approximately 1 y after diagnosis (1). Nevertheless, a subset of patients demonstrates long-term survival of 3 y or more (2). Prognostic factors that have been identified, such as age at diagnosis, Karnofsky Performance Score (KPS), and extent of resection, inadequately predict outcome (1,3-5). Moreover, although certain genetic factors have been associated with overall survival (OS), no sufficient, reliable, and validated biomarker has been established for clinical practice (2,6). The identification of prognostic variables in GBM patients is a major challenge and could increase the prognostic accuracy, identify patients who may benefit from more aggressive treatments, and allow for the selection of more homogeneous experimental populations in ongoing clinical trials. JBrain SPECT has been established as a useful tool for the evaluation of brain tumors (7-9). We have previously reported that 99m Tc-tetrofosmin uptake correlates with glioma proliferative potential, as assessed by the Ki-67 immunohistochemical index and flow cytometry (10,11). Because of the established prognostic value of Ki-67 in gliomas (12), we set out to investigate the correlation between pretreatment 99m Tc-tetrofosmin tumor uptake and OS in patients with GBM. MATERIALS AND METHODSWe prospectively studied 18 newly diagn...

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“…Morphological depiction of the brain by classic MRI and CT can merely recognize edema and BBB disruption, so it is usually inconclusive and faces inherent limitations in discriminating viable tumor from post-irradiation change (Byrne, 1994). Depiction of recurrent tumor was the first imaging challenge against which we evaluated 99m Tc-TF brain SPECT accuracy a few years back (Alexiou et al, 2007). A prospective ongoing study enrolled 24 patients that had been previously treated surgically for brain tumor followed by external beam radiotherapy, while some had also received adjuvant chemotherapy.…”

Section: Discriminating Recurrent Disease From Radiation Necrosis In mentioning

confidence: 99%

Metabolic Imaging of Brain Tumor by 99mTc-Tetrofosmin Scintitomography

Tsiouris¹,

Alexiou²,

Παπαδόπουλος³

et al. 2011

Diagnostic Techniques and Surgical Management of Brain Tumors

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Evaluation of brain tumor recurrence by 99mTc-tetrofosmin SPECT: a prospective pilot study

Abstract: Metabolic brain imaging by (99m)Tc-TF could offer useful information in the workup of treated brain tumors, where radiomorphologic findings between recurrence and radionecrosis are inconclusive.

Cited by 53 publications

References 22 publications

99mTc-Tetrofosmin SPECT for Glioma Evaluation

99mTc-Tetrofosmin SPECT for Glioma Evaluation

The Value of ^99mTc-Tetrofosmin Brain SPECT in Predicting Survival in Patients with Glioblastoma Multiforme

Metabolic Imaging of Brain Tumor by 99mTc-Tetrofosmin Scintitomography

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Evaluation of brain tumor recurrence by 99mTc-tetrofosmin SPECT: a prospective pilot study

Abstract: Metabolic brain imaging by (99m)Tc-TF could offer useful information in the workup of treated brain tumors, where radiomorphologic findings between recurrence and radionecrosis are inconclusive.

Cited by 53 publications

References 22 publications

99mTc-Tetrofosmin SPECT for Glioma Evaluation

99mTc-Tetrofosmin SPECT for Glioma Evaluation

The Value of 99mTc-Tetrofosmin Brain SPECT in Predicting Survival in Patients with Glioblastoma Multiforme

Metabolic Imaging of Brain Tumor by 99mTc-Tetrofosmin Scintitomography

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The Value of ^99mTc-Tetrofosmin Brain SPECT in Predicting Survival in Patients with Glioblastoma Multiforme