Dual-isotope single-photon emission computerized tomography scanning in patients with glioblastoma multiforme: association with patient survival and histopathological characteristics of tumor after high-dose radiotherapy

Rb, Schwartz; Bl, Holman; Jf, Polak; Bm, Garada; Ms, Schwartz; Folkerth, Rebecca D.; Pa, Carvalho; Js, Loeffler; Dc, Shrieve; Pm, Black; Alexander, Eben

doi:10.3171/jns.1998.89.1.0060

Cited by 44 publications

(30 citation statements)

References 29 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…In contrast to PET, which remains a highly expensive diagnostic modality, SPECT is widely available and routinely used, even in less developed countries. In previous studies, higher tracer uptake by glioma on SPECT was shown to be associated with higher grade and decreased response to chemotherapy of gliomas (11)(12)(13)(14). In addition, higher technetium-99m-methoxyisobutylisonitrile ( 99m Tc-MIBI) uptake was demonstrated to correlate with higher proliferative potential of gliomas and with worse survival (15)(16)(17)(18)(19).…”

Section: Introductionmentioning

confidence: 99%

Perioperative single photon emission computed tomography in predicting survival of malignant glioma patients

et al. 2012

View full text Add to dashboard Cite

Abstract. Single photon emission computed tomography (SPECT) is widely used in the evaluation of glioma patients and has been demonstrated to correlate with glioma malignancy and proliferation indexes. The aim of this study was to evaluate the association between perioperative technetium-99m-methoxyisobutylisonitrile ( 99m Tc-MIBI) uptake on SPECT scans and survival of malignant glioma patients. A total of 17 patients (11 males and 6 women; mean age, 62.2±8.4 years) with histologically confirmed malignant gliomas (16 glioblastoma multiforme and 1 gliosarcoma) underwent 99m Tc-MIBI SPECT scans 2.8±1.9 days before surgery and 9.8±1.5 days after surgery. The total intensity index (TII) that corresponds to the area and intensity of tracer uptake was calculated before and after surgery. In addition, the change of TII before versus after surgery (Δ TII) was calculated. The overall survival (OS) was defined as the period between the date of surgery and the date of death. The median overall survival time was 12.4 months, ranging from 1.4 to 88 months; there were nine (45%) 12-month survivors. In univariate analyses using a log-rank test, worse OS was significantly associated with higher preoperative TII (≥12), higher postoperative TII (≥6), lower Δ TII (<50%) and higher number of neurological symptoms prior to surgery (≥4). In multivariate analyses, higher postoperative TII, a greater number of neurological symptoms and female gender were found to be factors with independent prognostic value of OS. Patients who survived more than 12 months following surgery had a significantly lower postoperative TII, higher Δ TII and greater rate of gross total resection compared to patients who survived less than 12 months following surgery. Higher perioperative tracer uptake and lower decrease of tracer uptake following surgery (suggesting less radical resection) were associated with worse OS of malignant glioma patients. Our results suggest that SPECT may be used to predict survival of malignant glioma patients; however, further studies using larger samples are required.

show abstract

Section: Introductionmentioning

confidence: 99%

Perioperative single photon emission computed tomography in predicting survival of malignant glioma patients

et al. 2012

View full text Add to dashboard Cite

show abstract

“…That study also showed that the ADC ratios in the white matter tracts in the perilesional edema were significantly higher in patients with radiation injury compared with those with recurrent tumor and that the fractional anisotropy (FA) ratios were significantly higher in normal-appearing white matter tracts adjacent to the edema in patients diagnosed with radiation injury compared with those with recurrent tumors. 7 Thallium 201 ( 201 Tl) or 99mTc hexamethylpropyleneamine oxime single-photon emission tomography (HMPAO SPECT) or both [12][13][14] have been reported as useful techniques to discriminate tumor progression and radiation injury. It has been suggested that the combination of lowthallium and low-HMPAO uptake was associated with benign radiation change; whereas increased uptake of either agent or both was associated with recurrent/persistent tumor at biopsy and a poor prognosis.…”

mentioning

confidence: 99%

MR Spectroscopy in Radiation Injury

Sundgren¹

2009

AJNR Am J Neuroradiol

122

View full text Add to dashboard Cite

SUMMARY:Detecting a new area of contrast enhancement in or in the vicinity of a previously treated brain tumor always causes concern for both the patient and the physician. The question that immediately arises is whether this new lesion is recurrent tumor or a treatment effect. The differentiation of recurrent tumor or progressive tumor from radiation injury after radiation therapy is often a radiologic dilemma regardless the technique used, CT or MR imaging. The purpose of this article was to review the utility of one of the newer MR imaging techniques, MR spectroscopy, to distinguish recurrent tumor from radiation necrosis or radiation injury. N ew contrast enhancing lesions discovered on routine follow-up brain imaging at or near the site of previously treated primary brain tumor present a diagnostic dilemma. Posttreatment imaging features are often non-specific and the differentiation between recurrent tumor and radiation injury is often difficult. In attempts by investigators to improve local tumor control and the overall clinical outcome and survival for patients with primary brain tumor, new, more aggressive treatment protocols are implemented or tested. These protocols include different schemes of dosages of various chemotherapeutic agents but also different schemes of locally administered high doses of radiation.Although these new radiation schemes have resulted in improved outcome, they have also been associated with a significant incidence of radiation injury to the brain. It is well documented that there is a relationship between increased survival and increased total dose. 1 The risk of late effects that can lead to devastating functional deficits several months to years after brain irradiation limits the total dose that can safely be administrated to patients. Recent data suggest that progressive dementia occurs in approximately 20%-50% of patients with brain tumor who are long-term survivors after treatment with large-field partial-or whole-brain irradiation. 2The differentiation of recurrent tumor or progressive tumor from radiation injury after radiation therapy is often a radiologic dilemma, regardless of the technique used, CT or MR imaging. Most of these brain neoplasms have been subjected to radiation and/or chemotherapy, and many of the tumors do not have specific imaging characteristics that will enable the neuroradiologist to discriminate tumor recurrence from the inflammatory or necrotic change that can result from treatment with radiation and/or chemotherapy. Both entities typically demonstrate contrast enhancement. It is, therefore, often the clinical course, a brain biopsy, or imaging over a lengthy follow-up interval that enables the distinction of recurrent tumor from a treatment-related lesion, not the specific imaging itself.3 A noninvasive tool that could differentiate these entities when a new enhancing lesion is first identified would be invaluable. MR spectroscopy might be well suited for this purpose, provided that spectra of diagnostic quality can be obtained. This noninvasi...

show abstract

“…Recurrence was confirmed in 12 of their 13 patients, with 201 Tl tumor/scalp ratios of 3.5 or greater and with 99m Tc HMPAO tumor/cerebellum ratios of 0.51 or more. Schwartz et al 13 observed a similar relation, in terms of survival, using dual-isotope SPECT with 201 Tl and 99m Tc HMPAO. One-year survival was 6.7% if 201 Tl tumor/scalp ratios were 3.5 or greater and 99m Tc HMPAO tumor/cerebellum ratios were 0.51 or more, compared to 83% with 201 Tl tumor/scalp ratios of less than 2 and 99m Tc HMPAO tumor/cerebellum ratios less than 0.5.…”

Section: Discussionmentioning

confidence: 51%

“…[11][12][13][14][15][16] Most of these studies demonstrated the utility of 201 Tl-SPECT either alone or with dual-isotope SPECT with 99m Tc-hexamethylpropyleneamine oxime (HMPAO) in the follow-up evaluation of primary brain tumors. [13][14][15] A comparative assessment of 201 Tl-SPECT with CT was reported by Lorberboym et al 16 in high-grade gliomas following surgery, radiation, and/or chemotherapy during a mean follow-up period of 15 months. Because radiation-induced necrosis represents late radiation changes, studies with a longer duration of follow-up could further help to ascertain the predictive values of CT and 201 Tl-SPECT in post-irradiated brain tumors.…”

Section: Introductionmentioning

confidence: 99%

Comparative evaluation of 201 Tl SPECT and CT in the follow-up of irradiated brain tumors

Datta

Pasricha

Gambhir

et al. 2004

International Journal of Clinical Oncology

View full text Add to dashboard Cite

show abstract

Dual-isotope single-photon emission computerized tomography scanning in patients with glioblastoma multiforme: association with patient survival and histopathological characteristics of tumor after high-dose radiotherapy

Abstract: Dual-isotope SPECT data correlate with histopathological findings made at reoperation and with survival in patients with malignant gliomas after surgical and high-dose radiation therapy.

Cited by 44 publications

References 29 publications

Perioperative single photon emission computed tomography in predicting survival of malignant glioma patients

Perioperative single photon emission computed tomography in predicting survival of malignant glioma patients

MR Spectroscopy in Radiation Injury

Comparative evaluation of 201 Tl SPECT and CT in the follow-up of irradiated brain tumors

Contact Info

Product

Resources

About