title: Assessing response using 99mTc-MIBI early after interstitial chemotherapy with carmustine-loaded polymers in glioblastoma multiforme: preliminary results.
abstract: Introduction. Early signs of response after applying wafers of carmustine-loaded polymers (gliadel) are difficult to assess with imaging because of time-related imaging changes. (99m)Tc-sestamibi (MIBI) brain single-photon emission tomography (SPET) has reportedly been used to reveal areas of cellularity distinguishing recurrent neoplasm from radionecrosis. Our aim was to explore the role of MIBI SPET in assessing response soon after gliadel application in glioblastoma multiforme (GBM). Methods. We retrospectively reviewed the charts on 28 consecutive patients with a radiological diagnosis of GBM who underwent MIBI SPET/CT before surgery (with intracavitary gliadel placement in 17 patients), soon after surgery, and at 4 months. The area of uptake was selected using a volume of interest that was then mirrored contralaterally to obtain a semiquantitative ratio. Results. After adjusting for ratio at the baseline, the effect of treatment (gliadel versus non-gliadel) was not statistically significant. Soon after surgery, however, 100% of patients treated with gliadel had a decreased ratio, as opposed to 62.5% of patients in the non-gliadel group (P = 0.0316). The difference between ratios of patients with radical versus partial resection reached statistical significance by a small margin (P = 0.0528). Conclusions. These data seem to suggest that the MIBI ratio could be a valuable tool for monitoring the effect of gliadel early after surgery.
authors.affiliation: Nuclear Medicine Service, Department of Medicine (DIMED), University Hospital, 35128 Padova, Italy.
authors.forename: D
authors.initials: D
authors.lastname: Cecchin
authors.affiliation: Nuclear Medicine Service, Department of Medicine (DIMED), University Hospital, 35128 Padova, Italy.
authors.forename: I
authors.initials: I
authors.lastname: Schiorlin
authors.affiliation: Department of Neurosurgery, University Hospital, 35128 Padova, Italy.
authors.forename: A
authors.initials: A
authors.lastname: Della Puppa
authors.affiliation: Department of Medical Oncology 1, IOV, IRCCS, Venetian Oncology Institute, 35128 Padova, Italy.
authors.forename: G
authors.initials: G
authors.lastname: Lombardi
authors.affiliation: Nuclear Medicine Service, Department of Medicine (DIMED), University Hospital, 35128 Padova, Italy.
authors.forename: P
authors.initials: P
authors.lastname: Zucchetta
authors.affiliation: Nuclear Medicine Service, Department of Medicine (DIMED), University Hospital, 35128 Padova, Italy.
authors.forename: V
authors.initials: V
authors.lastname: Bodanza
authors.affiliation: Surgical Pathology & Cytopathology Unit, Department of Medicine (DIMED), University Hospital, 35128 Padova, Italy.
authors.forename: M P
authors.initials: MP
authors.lastname: Gardiman
authors.affiliation: Neuroradiology Unit, University Hospital, 35128 Padova, Italy.
authors.forename: G
authors.initials: G
authors.lastname: Rolma
authors.affiliation: Biostatistics, Epidemiology and Public Health Unit, Department of Cardiac, Thoracic and Vascular Sciences, University Hospital, 35128 Padova, Italy.
authors.forename: A C
authors.initials: AC
authors.lastname: Frigo
authors.affiliation: Nuclear Medicine Service, Department of Medicine (DIMED), University Hospital, 35128 Padova, Italy.
authors.forename: F
authors.initials: F
authors.lastname: Bui
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000970:Antineoplastic Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D002330:Carmustine / Q000008:administration & dosage / Q000627:therapeutic use*; D005260:Female; D005909:Glioblastoma / Q000453:epidemiology* / Q000628:therapy*; D006801:Humans; D008297:Male; D008875:Middle Aged; D012008:Recurrence; D012189:Retrospective Studies; D017256:Technetium Tc 99m Sestamibi / Q000008:administration & dosage / Q000627:therapeutic use*; D016896:Treatment Outcome
chemical_list: D000970:Antineoplastic Agents; D017256:Technetium Tc 99m Sestamibi; D002330:Carmustine