title: The value of 99mTc-tetrofosmin brain SPECT in predicting survival in patients with glioblastoma multiforme.
abstract: (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.
  
  
  METHODS
  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.
  
  
  RESULTS
  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.
  
  
  CONCLUSIONS
  (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.
authors.affiliation: Department of Neurosurgery, University Hospital of Ioannina, Ioannina, Greece. alexiougrg@yahoo.gr
authors.forename: George A
authors.initials: GA
authors.lastname: Alexiou
authors.forename: Spyridon
authors.initials: S
authors.lastname: Tsiouris
authors.forename: Athanasios P
authors.initials: AP
authors.lastname: Kyritsis
authors.forename: George
authors.initials: G
authors.lastname: Fotakopoulos
authors.forename: Anna
authors.initials: A
authors.lastname: Goussia
authors.forename: Spyridon
authors.initials: S
authors.lastname: Voulgaris
authors.forename: Andreas D
authors.initials: AD
authors.lastname: Fotopoulos
mesh_terms: D000368:Aged; D001921:Brain / Q000000981:diagnostic imaging*; D001932:Brain Neoplasms / Q000000981:diagnostic imaging* / Q000628:therapy*; D005260:Female; D005434:Flow Cytometry; D005909:Glioblastoma / Q000000981:diagnostic imaging* / Q000628:therapy*; D006801:Humans; D007090:Image Interpretation, Computer-Assisted; D007150:Immunohistochemistry; D053208:Kaplan-Meier Estimate; D017567:Karnofsky Performance Status; D019394:Ki-67 Antigen / Q000032:analysis; D008297:Male; D008875:Middle Aged; D009943:Organophosphorus Compounds; D015609:Organotechnetium Compounds; D011237:Predictive Value of Tests; D019275:Radiopharmaceuticals; D016019:Survival Analysis; D015899:Tomography, Emission-Computed, Single-Photon
chemical_list: D019394:Ki-67 Antigen; D009943:Organophosphorus Compounds; D015609:Organotechnetium Compounds; D019275:Radiopharmaceuticals; C078700:technetium tc-99m tetrofosmin