technetium-tc-99m-tetrofosmin and Glioblastoma

(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

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