title: Does (99m)Tc-Sestamibi in high-grade malignant brain tumors reflect blood-brain barrier damage only?
abstract: (99m)Tc-Sestamibi (MIBI) has been successfully applied in recurrent glioblastoma. The aim of this study was to evaluate the incremental diagnostic information of MIBI as a tumor-avid radiopharmaceutical compared with (99m)Tc-pertechnetate ((99m)Tc) as sole indicator of the integrity of the blood-brain barrier. Twenty-five patients with confirmed recurrent brain tumors were included. MIBI SPET was performed 10 min after injection of 555 MBq MIBI intravenously with a triple-headed gamma camera equipped with LE-UHR-PAR collimators over 360 degrees (3 degrees /step) and stored in a 128(2) matrix. Identical acquisition parameters were used for (99m)Tc SPET, which was acquired 3 h after injection of 740 MBq (99m)Tc. Normalized tumor uptake (NU) was calculated from attenuation-corrected transaxial slices. In addition, tumor/plexus, tumor/nasopharynx, and tumor/parotid gland ratios were assessed in both studies. No statistically significant differences were detected for the mean NU of tumor tissue with MIBI (0.26 +/- 0.10) and (99m)Tc (0.39 +/- 0. 33) and for the tumor/nasopharynx and tumor/parotid gland ratios; only the tumor/plexus ratio was significantly higher for (99m)Tc than for MIBI (p < 0.05). In conclusion, our data indicate that MIBI scintigraphy in brain tumors at 10 min postinjection reveals no additional visual information over that provided by the conventional (99m)Tc-pertechnetate brain scan, and in addition, tracer retention reflects primarily blood-brain barrier damage.
authors.affiliation: Department of Nuclear Medicine, University Hospital of Vienna-AKH, Waehringer-Guertel 18-20, A-1090, Vienna, Austria.
authors.forename: A
authors.initials: A
authors.lastname: Staudenherz
authors.forename: B
authors.initials: B
authors.lastname: Fazeny
authors.forename: C
authors.initials: C
authors.lastname: Marosi
authors.forename: C
authors.initials: C
authors.lastname: Nasel
authors.forename: M
authors.initials: M
authors.lastname: Hoffmann
authors.forename: S
authors.initials: S
authors.lastname: Puig
authors.forename: M
authors.initials: M
authors.lastname: Killer
authors.forename: T
authors.initials: T
authors.lastname: Leitha
mesh_terms: D000328:Adult; D001812:Blood-Brain Barrier; D001932:Brain Neoplasms / Q000000981:diagnostic imaging* / Q000378:metabolism*; D005260:Female; D005909:Glioblastoma / Q000000981:diagnostic imaging* / Q000378:metabolism; D006801:Humans; D008297:Male; D008875:Middle Aged; D009837:Oligodendroglioma / Q000000981:diagnostic imaging* / Q000378:metabolism; D011877:Radionuclide Imaging; D019275:Radiopharmaceuticals; D013670:Sodium Pertechnetate Tc 99m; D017256:Technetium Tc 99m Sestamibi
chemical_list: D019275:Radiopharmaceuticals; D017256:Technetium Tc 99m Sestamibi; D013670:Sodium Pertechnetate Tc 99m