False-negative Tc-99m MIBI scintigraphy in histopathologically proved recurrent high-grade oligodendroglioma.
Tc-99m MIBI is a small lipophilic radioligand that enters cells by diffusion and is preferentially trapped in mitochondria. As a result of the high mitochondrial activity in tumors, Tc-99m MIBI accumulates significantly more in tumor tissue compared with normal tissues. Accordingly, Tc-99m MIBI has been used successfully to visualize primary, metastatic, and recurrent tumor. In brain tumors, Tc-99m MIBI SPECT has been shown to identify tumor recurrence after treatment in high-grade gliomas. In this report, early (30 minutes after injection) and delayed (4 hours after injection) Tc-99m MIBI SPECT did not visualize a histopathologically proved recurrent high-grade oligodendroglioma. Increased vascular supply, disruption of the blood-brain barrier, high-grade cancer, and viability of tumor cells are decisive factors related to increased Tc-99m MIBI uptake in brain tumors. However, the authors' results suggest that still other mechanisms may be involved in Tc-99m MIBI accumulation, which may account for false-negative imaging in brain tumors.
Goethals
Ingeborg
I
Division of Nuclear Medicine, Ghent University Hospital, Belgium. ingeborg.goethals@rug.ac.be
De Winter
Oliver
O
Dierckx
Rudi
R
Annovazzi
Allessio
A
Signore
Alberto
A
van de Wiele
Christophe
C
D000328:Adult; D001932:Brain Neoplasms / Q000000981:diagnostic imaging / Q000473:pathology; D005188:False Negative Reactions; D005260:Female; D006801:Humans; D009364:Neoplasm Recurrence, Local / Q000000981:diagnostic imaging* / Q000473:pathology*; D009837:Oligodendroglioma / Q000000981:diagnostic imaging* / Q000473:pathology*; D011237:Predictive Value of Tests; D019275:Radiopharmaceuticals; D017256:Technetium Tc 99m Sestamibi; D015899:Tomography, Emission-Computed, Single-Photon / Q000379:methods
D019275:Radiopharmaceuticals; D017256:Technetium Tc 99m Sestamibi