Evaluation of pediatric CNS malignancies with (99m)Tc-methoxyisobutylisonitrile SPECT.
SPECT has the potential to add valuable information to the diagnosis and management of central nervous system (CNS) malignancy. Radioactive tracers including (99m)Tc-methoxyisobutylisonitrile (MIBI), or sestamibi, have been shown to be sensitive markers for brain tumors; however, their role in imaging children is poorly defined.


METHODS
We undertook a pilot study of 29 pairs of (99m)Tc-MIBI and MRI images from 20 children to explore the clinical usefulness of this tracer in CNS malignancy.


RESULTS
Tumor types that took up (99m)Tc-MIBI included brain stem glioma, fibrillary astrocytoma, other low-grade astrocytomas, and glioblastoma multiforme. Most tumors positive for (99m)Tc-MIBI uptake were astrocytomas, including those in the brain stem, cerebellum, and cortex. This method of nuclear imaging not only was able to identify the presence of a tumor but also could identify changes in the same tumor over time. Some correlation between histologic grade and (99m)Tc-MIBI uptake was observed. Several tumors, including craniopharyngioma, medulloblastoma, and optic glioma, were evident on MRI but not on (99m)Tc-MIBI SPECT.


CONCLUSIONS
The results suggest that this modality is a potentially useful tool in the diagnosis and management of CNS malignancies, particularly higher-grade astrocytomas, in children.
Kirton
Adam
A
Department of Pediatrics, Alberta Children's Hospital, University of Calgary, Canada. adamkirton@hotmail.com
Kloiber
Reinhard
R
Rigel
Jane
J
Wolff
Johannes
J
D000293:Adolescent; D001932:Brain Neoplasms / Q000175:diagnosis / Q000000981:diagnostic imaging; D020295:Brain Stem Neoplasms / Q000175:diagnosis / Q000000981:diagnostic imaging; D016543:Central Nervous System Neoplasms / Q000175:diagnosis / Q000000981:diagnostic imaging*; D002648:Child; D002675:Child, Preschool; D005260:Female; D005910:Glioma / Q000175:diagnosis / Q000000981:diagnostic imaging*; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D010865:Pilot Projects; D019275:Radiopharmaceuticals; D013125:Spinal Neoplasms / Q000175:diagnosis / Q000000981:diagnostic imaging; D017256:Technetium Tc 99m Sestamibi; D015899:Tomography, Emission-Computed, Single-Photon
D019275:Radiopharmaceuticals; D017256:Technetium Tc 99m Sestamibi