technetium-tc-99m-tetrofosmin and Brain-Neoplasms

[(99m)TC]sestamibi and [(99m)TC]tetrofosmin are two lipophilic cationic complexes which were originally employed in myocardial perfusion imaging and then later applied as tumor-seeking agents in the evaluation of diverse human malignancies. Despite the wider use of fluorine-18-labeled fluorodeoxyglucose positron emission tomography (FDG-PET) in cancer imaging, the two cationic lipophilic agents still play a useful clinical role in oncology when single-photon emission computed tomography (SPET) instead of planar is used as the acquisition method. This review summarizes the results of studies on the use of these radiopharmaceuticals in lung cancer, malignant lymphomas and brain tumors. Their performance in the diagnosis and staging of the primary tumor, the prediction of cancer response to therapy, the monitoring of treatment and the detection of recurrence during follow-up is also compared. Numerous studies have shown that SPET procedures are highly sensitive and accurate in tumor patient management. However, the main limitation to both SPET and planar imaging alike is that under some conditions the images do not give a clear structural delineation of the pathologic processes detected with these procedures. This sometimes makes SPET images difficult to interpret and so reduces its diagnostic performance. Recently available hybrid SPET/CT devices appear to overcome this problem by providing both functional and anatomical data. Preliminary reports on SPET/CT in tumor imaging have demonstrated that SPET/CT can provide more clinical information than SPET or CT alone in some cases. The possible role of integrated dual-modality images using SPET with SM or TF is also briefly discussed.

Topics: Brain Neoplasms; Humans; Lung Neoplasms; Lymphoma; Medical Oncology; Organophosphorus Compounds; Organotechnetium Compounds; Radiopharmaceuticals; Subtraction Technique; Technetium Tc 99m Sestamibi; Tomography, Emission-Computed, Single-Photon; Tomography, X-Ray Computed

Treatment induced necrosis is a relatively frequent finding in patients treated for high-grade glioma. Differentiation by imaging modalities between glioma recurrence and treatment induced necrosis is not always straightforward. This is a comparative study of diffusion tensor imaging (DTI), dynamic susceptibility contrast MRI and (99m)Tc-Tetrofosmin brain single-photon emission computed tomography (SPECT) for differentiation of recurrent glioma from treatment induced necrosis.. A prospective study was made of 30 patients treated for high-grade glioma who had suspected recurrent tumor on follow-up MRI. All had been treated by surgical resection of the tumor followed by standard postoperative radiotherapy with chemotherapy. No residual tumor had been found on brain imaging immediately after the initial treatment. All the patients were studied with dynamic susceptibility contrast brain MRI and, within a week, (99m)Tc-Tetrofosmin brain SPECT.. Both (99m)Tc-Tetrofosmin brain SPECT and dynamic susceptibility contrast MRI could discriminate between tumor recurrence and treatment induced necrosis with 100% sensitivity and 100% specificity. An apparent diffusion coefficient (ADC) ratio cut-off value of 1.27 could differentiate recurrence from treatment induced necrosis with 65% sensitivity and 100% specificity and a fractional anisotropy (FA) ratio cut-off value of 0.47 could differentiate recurrence from treatment induced necrosis with 57% sensitivity and 100% specificity. A significant correlation was demonstrated between (99m)Tc-Tetrofosmin uptake ratio and rCBV (P=0.003).. Dynamic susceptibility contrast MRI and brain SPECT with (99m)Tc-Tetrofosmin had the same accuracy and may be used to detect recurrent tumor following treatment for glioma. DTI also showed promise for the detection of recurrent tumor, but was inferior to both dynamic susceptibility contrast MRI and brain SPECT.

Topics: Brain; Brain Neoplasms; Chemoradiotherapy; Contrast Media; Diagnosis, Differential; Diffusion Tensor Imaging; Female; Glioma; Humans; Male; Middle Aged; Necrosis; Neoplasm Recurrence, Local; Organophosphorus Compounds; Organotechnetium Compounds; Radiation Injuries; Radiopharmaceuticals; Tomography, Emission-Computed, Single-Photon; Treatment Outcome

Differentiating neoplastic from non-neoplastic intracranial lesions is of paramount importance for patient management. Benign lesions can have many of the features of malignant brain tumors on both computed tomography (CT) and conventional magnetic resonance imaging (MRI). Herewith, we set out to investigate the role of (99m)Tc-Tetrofosmin (⁹⁹(m)Tc-TF) brain SPECT in the differentiation of neoplastic from non-neoplastic intracranial lesions. We prospectively studied, between September 2004 and September 2009, patients with intracranial lesions suspected of being tumors on CT/MRI that were operated on. All patients with suspected tumor on CT/MRI underwent ⁹⁹(m)Tc-TF brain SPECT within a week before surgery and CT/MRI studies. Radiotracer accumulation in intracranial lesions was assessed visually and then a semiquantitative method of image analysis was applied, by calculating the lesion-to-normal (L/N) uptake ratio. We compared the L/N ratios between low-grade gliomas and high-grade gliomas, low and high-grade gliomas and intra-axial non-neoplastic lesions, low and high-grade gliomas and metastases, and typical versus anaplastic meningiomas Ninety patients suffered from neoplastic lesions and 16 harboured non-neoplastic pathologies. There was a significant difference between low-grade gliomas and high-grade gliomas (P = 0.0019). ROC analysis provided 2.8 as the optimum cutoff value thresholding discrimination between these two groups, with 91.3% sensitivity and 83.3% specificity. When comparing gliomas (low and high-grade) with intra axial non-neoplastic lesions the difference was statistically significant (P < 0.0001). There was no statistically significant difference between gliomas (low and high-grade) and metastases. Regarding meningiomas, there was a statistically significant difference between typical and anaplastic meningiomas (P = 0.0002). ROC analysis provided 9.6 as the optimum cutoff value thresholding discrimination between these two groups, with 96% sensitivity and 100% specificity. (99m)Tc-TF brain SPECT may differentiate neoplastic from non-neoplastic intracranial pathologies and could prove useful for pre-surgical evaluation of intracranial lesions.

Topics: Adult; Aged; Brain Diseases; Brain Neoplasms; Female; Humans; Male; Middle Aged; Organophosphorus Compounds; Organotechnetium Compounds; Radiopharmaceuticals; ROC Curve; Sensitivity and Specificity; Tomography, Emission-Computed, Single-Photon; Young Adult

To evaluate the relative and combined utility of. Thirty-six patients with clinically suspected brain tumours were assessed by. Both imaging techniques,

Topics: Adult; Aged; Aged, 80 and over; Brain; Brain Neoplasms; Female; Humans; Magnetic Resonance Angiography; Male; Middle Aged; Multimodal Imaging; Neoplasm Grading; Organophosphorus Compounds; Organotechnetium Compounds; Radiopharmaceuticals; Sensitivity and Specificity; Tomography, Emission-Computed, Single-Photon; Young Adult

Assessment of the grade and type of glioma is of paramount importance for prognosis. Tumour proliferative potentials may provide additional information on the behaviour of the tumour, its response to treatment and prognosis. The purpose of this study was to investigate the correlation between diffusion tensor imaging (DTI), dynamic susceptibility contrast (DSC) magnetic resonance imaging (MRI) and (99m)Tc-Tetrofosmin brain single-photon emission computed tomography (SPECT), and the tumour grade and Ki-67 labelling index in newly diagnosed gliomas.. Study was made of patients with suspected glioma on brain MRI between December 2010 and January 2012, by DTI, DSC MRI and (99m)Tc-Tetrofosmin brain SPECT. The proliferative activity of each tumour was measured by deriving the Ki-67 proliferation index from immunohistochemical staining of tumour specimens.. Glioma was newly diagnosed in 25 patients (17 men, 8 women, aged 19-79 years, median 55 years). The Ki-67 index ranged from 1% to 80% (mean 19.4%). On evaluation of the relationship between the (99m)Tc-Tetrofosmin tumour uptake by gliomas was found to be significantly correlated with cellular proliferation (rho=0.924, p<0.0001). Regarding DTI, significant negative correlation was demonstrated between the apparent diffusion coefficient (ADC) ratio and the Ki-67 index (rho=-0.545, p=0.0087). Significant correlation was also observed between the fractional anisotropy (FA) ratio and the Ki-67 index (rho=0.489, p=0.02). Strong correlation was found between relative cerebral blood volume (rCBV) and Ki-67 index (rho=0.853, p<0.0001), and between the (99m)Tc-Tetrofosmin lesion-to-normal (L/N) uptake ratio and rCBV (rho=0.808, p ≤ 0.0001). Significant negative correlation was demonstrated between the (99m)Tc-Tetrofosmin L/N ratio and ADC ratio (rho=-0.513, p=0.014). These imaging techniques were able to distinguish between low-grade and high-grade gliomas.. Findings on DSC MRI and brain SPECT with (99m)Tc-Tetrofosmin metrics were more closely correlated with glioma cellular proliferation.

Topics: Adult; Aged; Brain; Brain Neoplasms; Diffusion Tensor Imaging; Ethylenediamines; Female; Glioma; Humans; Immunohistochemistry; Ki-67 Antigen; Magnetic Resonance Imaging; Male; Middle Aged; Neoplasm Grading; Organophosphorus Compounds; Organotechnetium Compounds; Tomography, Emission-Computed, Single-Photon; Young Adult

Topics: Brain Neoplasms; Humans; Organophosphorus Compounds; Organotechnetium Compounds; Phenylalanine; Prospective Studies; Radiopharmaceuticals; Reproducibility of Results; Sensitivity and Specificity; Tomography, Emission-Computed, Single-Photon

(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)Tc-tetrofosmin brain SPECT in patients with glioblastoma multiforme.. We prospectively studied 18 patients (13 men, 5 women; mean age ± SD, 60.8 ± 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.. 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.. (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.

Topics: Aged; Brain; Brain Neoplasms; Female; Flow Cytometry; Glioblastoma; Humans; Image Interpretation, Computer-Assisted; Immunohistochemistry; Kaplan-Meier Estimate; Karnofsky Performance Status; Ki-67 Antigen; Male; Middle Aged; Organophosphorus Compounds; Organotechnetium Compounds; Predictive Value of Tests; Radiopharmaceuticals; Survival Analysis; Tomography, Emission-Computed, Single-Photon

We evaluated the value of single-photon emission computed tomography/computed tomography (SPECT/CT) with a hybrid camera for (99m)Tc-tetrofosmin (TF) imaging of brain tumors and metastases after radiotherapy.. Forty (40) patients (27 with primary brain tumors and 13 with intracranial metastases) were examined 6 months after radiation therapy. SPECT images were first evaluated alone and then reinterpreted by adding the anatomic (CT) data. Tumor-to-background ratio values were calculated in the nonattenuation-corrected (T1/B1) and in the CT-attenuation-corrected (T2/B2) images. Scintigraphic results were compared with clinical follow-up.. SPECT was true positive for viable tumor tissue in 21 patients and negative in 19. SPECT/CT contributed in 10 of 40 patients (25%): It improved the visualization of lesions in the deep temporal lobe, in the orbital region, and in the posterior fossa. SPECT/CT was useful in 4 of 8 patients with suspicion of radionecrosis. The hybrid camera did not significantly contribute both in patients with a negative scan or with large frontotemporal tumors. When all the lesions were considered, no significant difference was found between T1/B1 and T2/B2. In small lesions (<2 cm), T2/B2 was significantly higher (p = 0.04) than T1/B1. When the clinical outcome was considered, patients with a significant SPECT/CT contribution had a longer average survival than patients with a positive scan, in which the hybrid camera did not provide any substantial information (13.3 vs. 8.2 months; p = 0.0007).. Hybrid SPECT/CT can be useful to better characterize small lesions that are deeply located and in areas of high physiologic background. Further studies and larger series are needed to more accurately define the potential clinical impact of hybrid imaging in patients' management.

Topics: Brain Neoplasms; Female; Humans; Male; Middle Aged; Organophosphorus Compounds; Organotechnetium Compounds; Radiopharmaceuticals; Tomography, Emission-Computed, Single-Photon; Tomography, X-Ray Computed

Brain single-photon emission computed tomography (SPECT) has been proposed as a potentially useful modality for the metabolic assessment of various brain tumors.. In a 10-patient prospective pilot study we evaluated whether (99m)Tc-Tetrofosmin ((99m)Tc-TF) uptake correlates with glioma proliferative activity assessed by flow cytometric analysis. (99m)Tc-TF brain SPECT was performed shortly before surgical tumor excision.. Eight patients were diagnosed with glioblastoma multiform and 2 with anaplastic astrocytoma. All tumors were aneuploid. We found a significant positive linear correlation between (99m)Tc-TF uptake and percentage of tumor cells on the S-phase of the cell cycle (r=0.92, P=0.001).. Initial evidence suggests that (99m)Tc-TF could provide a non-invasive indicator of glioma proliferative activity.

Topics: Aged; Aneuploidy; Brain Neoplasms; Cell Proliferation; DNA; Female; Flow Cytometry; Gamma Cameras; Glioblastoma; Glioma; Humans; Image Processing, Computer-Assisted; Male; Middle Aged; Organophosphorus Compounds; Organotechnetium Compounds; Pilot Projects; Prospective Studies; Radiopharmaceuticals; Tomography, Emission-Computed, Single-Photon

Topics: Brain Neoplasms; Glioma; Humans; Image Processing, Computer-Assisted; Magnetic Resonance Imaging; Organophosphorus Compounds; Organotechnetium Compounds; Radiotherapy Planning, Computer-Assisted; Sensitivity and Specificity; Technetium Tc 99m Sestamibi; Tomography, Emission-Computed, Single-Photon

Topics: Brain Neoplasms; Glioma; Humans; Organophosphorus Compounds; Organotechnetium Compounds; Radiopharmaceuticals; Tomography, Emission-Computed, Single-Photon

Topics: Brain Neoplasms; Clinical Trials as Topic; Glioma; Humans; Necrosis; Neoplasm Recurrence, Local; Organophosphorus Compounds; Organotechnetium Compounds; Prognosis; Radionuclide Imaging; Reproducibility of Results; Thallium Radioisotopes; Tomography, Emission-Computed, Single-Photon

Topics: Brain; Brain Neoplasms; Diagnosis, Differential; Humans; Magnetic Resonance Imaging; Necrosis; Neoplasm Metastasis; Organophosphorus Compounds; Organotechnetium Compounds; Positron-Emission Tomography; Radiation Injuries; Radiopharmaceuticals; Recurrence; Tomography, Emission-Computed, Single-Photon

Topics: Brain Neoplasms; Cell Proliferation; Female; Glioma; Humans; Ki-67 Antigen; Male; Middle Aged; Organophosphorus Compounds; Organotechnetium Compounds; Radiopharmaceuticals; Tomography, Emission-Computed, Single-Photon

Topics: Brain Neoplasms; Glioblastoma; Glioma; Humans; Neoplasm Staging; Organophosphorus Compounds; Organotechnetium Compounds; Prognosis; Radiopharmaceuticals; Tomography, Emission-Computed, Single-Photon

The differentiation between brain tumor recurrence and post-irradiation injury remains an imaging challenge. Computed tomography (CT) and magnetic resonance imaging (MRI) cannot always distinguish between the two. Although glioma cell line studies substantiated a plausible imaging superiority of (99m)Tc-tetrofosmin ((99m)Tc-TF) over other radiopharmaceuticals, little has been reported on its in vivo imaging properties. We assessed (99m)Tc-TF single-photon emission CT (SPECT) in cases where morphologic brain imaging was inconclusive between recurrence and radionecrosis.. A total of 11 patients (7 men, 4 women) were evaluated. The initial diagnosis was glioblastoma multiforme (4), anaplastic astrocytoma (1), anaplastic oligodendroglioma (3), grade-II astrocytoma (2), and low-grade oligodendroglioma (1). All patients had been operated on and then received adjuvant external-beam radiotherapy. After a mean follow-up period of 25 months, there was clinical suspicion of recurrence, for which (99m)Tc-TF SPECT was performed.. In 8/11 cases, an abnormally increased tracer uptake appeared in the region that CT and/or MRI indicated as suspicious; in half of these cases, recurrence was confirmed histologically after surgery and in the other four by growth of the lesion over a 6-month follow-up period, and clinical deterioration. The remaining 3/11 patients had faint tracer uptake in the suspicious region, compatible with radiation injury; these lesions remained morphologically unaltered in a mean 12-month follow-up period, with no clinical deterioration in the patient's condition, a course strongly favoring the diagnosis of radiation injury.. 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.

Topics: Adult; Brain; Brain Neoplasms; Cell Line, Tumor; Female; Glioma; Humans; Magnetic Resonance Imaging; Male; Middle Aged; Organophosphorus Compounds; Organotechnetium Compounds; Pilot Projects; Radiopharmaceuticals; Recurrence; Tomography, Emission-Computed, Single-Photon; Tomography, X-Ray Computed

Topics: Brain; Brain Neoplasms; Diagnosis, Differential; Diffusion Magnetic Resonance Imaging; Glioma; Humans; Neoplasm Recurrence, Local; Organophosphorus Compounds; Organotechnetium Compounds; Positron-Emission Tomography; Radiation Injuries; Radiopharmaceuticals; Tomography, Emission-Computed, Single-Photon

The aims of this study were to assess the clinical usefulness of [Tc-99m] tetrofosmin (TF) single photon emission computed tomography (SPECT) and X-ray transmission computed tomography (CT), performed simultaneously with a hybrid imaging device for the functional anatomical mapping of brain tumors and to evaluate the additional information of SPECT/CT when compared to SPECT alone. Thirty (30) patients were studied: 20 were evaluated before undergoing surgery and 10 after surgery and before radiotherapy planning. The acquisition of both functional (SPECT) and morphologic (CT) images were obtained in a single session. SPECT images were firstly evaluated alone and then reinterpreted by adding the anatomical (CT) planes. Fusion imaging was successfully obtained in all patients with precise correspondence between SPECT and CT slices. SPECT/CT had a significant clinical impact in 13 (43.3%) of 30 cases; in particular, SPECT/CT accurately characterized eight lesions near sites of physiological uptake (i.e., four near ventricles/choroids plexus, three near venous sinuses, one near the skull) and localized viable tumor tissue in 5 patients evaluated after surgery. SPECT/CT with TF using this hybrid device represents a useful clinical tool in brain tumor imaging, both correctly categorizing focal areas near sites of physiological uptake and localizing viable tumor tissue after surgery.

Topics: Adult; Aged; Brain Mapping; Brain Neoplasms; Female; Glioma; Humans; Male; Middle Aged; Organophosphorus Compounds; Organotechnetium Compounds; Photons; Radiopharmaceuticals; Reproducibility of Results; Sensitivity and Specificity; Tomography, Emission-Computed, Single-Photon; Tomography, X-Ray Computed

Topics: Brain Neoplasms; Carcinoma, Renal Cell; Cerebellar Diseases; Diagnosis, Differential; Humans; Intracranial Hemorrhages; Kidney Neoplasms; Male; Middle Aged; Organophosphorus Compounds; Organotechnetium Compounds; Radiopharmaceuticals; Tomography, Emission-Computed, Single-Photon

Despite a favourable prognosis, pilocytic astrocytomas may exhibit signs of malignancy on various neuroimaging modalities. This retrospective analysis was conducted to determine whether scintigraphic features of malignancy are also found on single-photon emission tomography (SPET) using L-3-[123I]iodo-alpha-methyl tyrosine (IMT) as a tracer. Twenty patients with pilocytic astrocytomas were retrospectively selected from a large series of patients referred for the evaluation of primary or recurrent brain tumours. IMT SPET was performed in 16 patients, positron emission tomography (PET) using 2-[18F]fluoro-2-deoxy-D-glucose (FDG) was available in 10 of the patients and SPET using technetium-99m tetrofosmin or thallium-201 had been performed in 11. Image analysis was performed using standard protocols to determine how many patients exceeded the respective thresholds of malignancy. Features of malignancy were found in 7/16 IMT SPET studies, in 7/10 FDG PET studies and in 7/11 of the residual SPET investigations. A significant correlation of tumour size and IMT uptake in primary pilocytic astrocytomas indicated partial volume effects to partly account for the differential uptake behaviour (n = 10, r = 0.87, P < 0.05). Differences in IMT uptake in primaries (1.7 +/- 0.6, n = 10) and in recurrent tumours (2.3 +/- 0.7, n = 6) did not attain statistical significance. IMT SPET results indicative of malignancy are regularly found in pilocytic astrocytomas, despite their good prognosis. No uptake may be detected in largely cystic or in small tumours.

Topics: Adolescent; Adult; Astrocytoma; Brain Neoplasms; Child; Child, Preschool; Female; Fluorodeoxyglucose F18; Humans; Infant; Magnetic Resonance Imaging; Male; Methyltyrosines; Middle Aged; Organophosphorus Compounds; Organotechnetium Compounds; Radiopharmaceuticals; Retrospective Studies; Tomography, Emission-Computed; Tomography, Emission-Computed, Single-Photon; Tomography, X-Ray Computed

The objective of this study was to compare the accumulation of Tc-99m-tetrofosmin and Tc-99m-sestamibi in four grade IV glioma cell lines and to correlate their accumulation with the multidrug resistance of the cells. Tc-99m-tetrofosmin in all glioma cell lines showed slightly higher uptake and more efficient release beyond 150 min than Tc-99m-sestamibi and the retention of both tracers in the cells was to a certain extend inversely proportional to their degree of multidrug resistance. The results obtained showed that the efflux of both tracers was carried out only in part through the MRP/GS-X pump system. Tc-99m-tetrofosmin showed good potential as a marker of recurrent malignant glioma and in vivo studies are currently underway to confirm these observations.

Topics: Antibodies, Monoclonal; ATP-Binding Cassette Transporters; Biomarkers, Tumor; Brain Neoplasms; Flow Cytometry; Genes, MDR; Glioma; Glutathione; Humans; Immunoglobulin G; Multidrug Resistance-Associated Proteins; Organophosphorus Compounds; Organotechnetium Compounds; Radiopharmaceuticals; Technetium Tc 99m Sestamibi

The purpose of the present study was to assess the ability of technetium-99m-tetrofosmin (99mTc-TF) to predict tumor malignancy and to compare its uptake with that of thallium-201 (201Tl), technetium-99m-hexakis-2-methoxyisobutyl isonitrile (99mTc-MIBI) and fluorine-18-fluorodeoxyglucose (18F-FDG) in brain tumors. 99mTc-TF single-photon emission computed tomography (SPECT) imaging was performed in 22 patients with brain tumors and 3 healthy controls. Some of the patients underwent 201Tl (n = 12) and 99mTc-MIBI SPECT (n = 14) and 18F-FDG positron emission tomography (PET) (n = 12). The radioactivity ratio of tumor to contralateral normal tissue (T/N) and the ratio of tumor to contralateral white matter (T/WM) were calculated in SPECT and PET images, respectively. In healthy controls, 99mTc-TF uptake was seen only in scalp, in the choroid plexus and pituitary gland, but not in normal cerebral parenchyma. TF T/N in low grade gliomas (2.8+/-0.4) was significantly lower than that in high grade gliomas (22.5+/-29.8) and malignant non-gliomas (8.3+/-2.8) without overlap of values (p = 0.003 and p = 0.014, respectively). TF T/N was significantly correlated with MIBI T/N (p = 0.92, p = 0.001), Tl T/N (p = 0.72, p = 0.017), and FDG T/WM (p = 0.65. p = 0.031). There was an excellent agreement between TF T/N and MIBI T/N values on linear regression analysis (MIBI T/N = -0.63+/-0.97 x TF T/N). These preliminary results indicate that SPECT imaging with 99mTc-TF may be useful for the non-invasive grading of brain tumors. They also suggest that 99mTc-TF and 99mTc-MIBI may accumulate in brain tumors by a similar mechanism or in relation to a similar process of tumor cell proliferation.

Topics: Adolescent; Adult; Aged; Brain Neoplasms; Child; Female; Fluorodeoxyglucose F18; Humans; Male; Middle Aged; Organophosphorus Compounds; Organotechnetium Compounds; Prognosis; Radiopharmaceuticals; Technetium Tc 99m Sestamibi; Thallium Radioisotopes; Tomography, Emission-Computed; Tomography, Emission-Computed, Single-Photon

The aim of this study was to evaluate Tc-99m-tetrofosmin whole-body imaging in the detection of metastases in patients with malignant melanoma.. In 30 patients with suspected melanoma metastases we performed whole body imaging. After administration of about 600 MBq Tc-99m-tetrofosmin dynamic images up to 10 min were performed in 7 patients (1 image per 10 sec) to evaluate the optimal tracer uptake in the metastases. In all patients whole-body images were performed 5-10 min p.i. using an acquisition time of 5 min per image. The final diagnosis was confirmed by surgical histology in 30 lesions, by computertomography and clinical course in the remaining lesions.. Out of 64 melanoma metastases 49 were detected using Tc-99m-tetrofosmin scintigraphy (49 rp., 15 fn.). The overall sensitivity for the detection of malignant lesions was 77%. Referring only to the lymph node metastases, the sensitivity was 87% (26 rp.; 4 fn.). The maximal tracer uptake was reached 1 min after injection, with a slow decrease in the following 10 minutes. The size of the lesions ranged between 0.5 and 7.0 cm and the T/B ratios between 1.3 and 3.0 (mean 1.88).. Tc-99m-tetrofosmin whole body imaging is a simple and side-effectless method for the detection of melanoma metastases especially of lymph node metastases. The results are comparable to Tc-99m-sestamibi and Tl-201 scintigraphy.

Topics: Adult; Aged; Brain Neoplasms; Female; Humans; Lymphatic Metastasis; Male; Melanoma; Middle Aged; Neoplasm Metastasis; Organophosphorus Compounds; Organotechnetium Compounds; Radionuclide Imaging; Radiopharmaceuticals; Sensitivity and Specificity

Thallium-201 is clinically used for the assessment of primary and recurrent brain tumors. The biologic properties of 201Tl that allow it to accumulate within the tumor cells render 201Tl useful in evaluating tumor malignancy, but its physical characteristics and nonroutine availability limits its use in some institutions, as compared to 99mTc-labeled compounds. The aim of this study was to assess the feasibility of using 99mTc-tetrofosmin for imaging brain tumors and to compare its uptake with that of 201Tl.. Twenty-six patients with 27 intracranial masses were studied with SPECT. In the first group of seven patients (Group A), the timing for optimal acquisition of the 99mTc-tetrofosmin scan was assessed. In the second group of 19 patients (Group B), two sequential 201Tl (74-148 MBq intravenous) and 99mTc-tetrofosmin (740-925 MBq intravenous) studies were performed 20 min after tracer injection and compared.. In Group A, no significant difference in the tumor-to-background (T/B) ratio among the 20-, 40- and 120-min postinjection studies was observed. In Group B, the quality of reconstructed images with 99mTc-tetrofosmin, judged visually, was superior to that of 201Tl in 47% of all studies and was comparable in the remaining 53%. A significant relationship between 201Tl and 99mTc-tetrofosmin T/B ratio (r = 0.75, p < 0.01) was found. The T/B ratio of 99mTc-tetrofosmin was significantly higher than that of 201Tl (23.3 +/- 21.5 compared to 6.1 +/- 2.9, p < 0.005).. Technetium-99m-tetrofosmin is a suitable radiotracer for the imaging of intracranial lesions with SPECT. Moreover, a better definition of tumor margins and a higher contrast between neoplastic and normal brain tissue can be achieved.

Topics: Brain Neoplasms; Feasibility Studies; Female; Humans; Image Processing, Computer-Assisted; Magnetic Resonance Imaging; Male; Middle Aged; Organophosphorus Compounds; Organotechnetium Compounds; Radiopharmaceuticals; Thallium; Thallium Radioisotopes; Tomography, Emission-Computed, Single-Photon; Tomography, X-Ray Computed

Topics: Adenocarcinoma; Aged; Brain Neoplasms; Female; Humans; Lung Neoplasms; Lymphatic Metastasis; Organophosphorus Compounds; Organotechnetium Compounds; Radiopharmaceuticals; Tomography, Emission-Computed, Single-Photon