Staudenherz A, Fazeny B, Marosi C, Nasel C, Hoffmann M, Puig S, Killer M, Leitha T
Department of Nuclear Medicine, University Hospital of Vienna-AKH, Waehringer-Guertel 18-20, A-1090, Vienna, Austria.
Neuroimage. 2000 Jul;12(1):109-11. doi: 10.1006/nimg.2000.0594.
(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.
锝-99m（99mTc）-甲氧基异丁基异腈（MIBI）已成功应用于复发性胶质母细胞瘤。本研究的目的是评估MIBI作为一种肿瘤摄取放射性药物相对于高锝酸盐（99mTc）作为血脑屏障完整性唯一指标所增加的诊断信息。纳入了25例确诊为复发性脑肿瘤的患者。静脉注射555 MBq MIBI后10分钟，使用配备低能通用高分辨率平行孔准直器的三头γ相机进行360度（3度/步）的MIBI单光子发射计算机断层显像（SPET），并存储在128×128矩阵中。99mTc SPET采用相同的采集参数，在注射740 MBq 99mTc后3小时进行采集。从经衰减校正的横轴断层图像计算标准化肿瘤摄取（NU）。此外，在两项研究中均评估了肿瘤/神经丛、肿瘤/鼻咽和肿瘤/腮腺的比值。MIBI组（0.26±0.10）和99mTc组（0.39±0.33）肿瘤组织的平均NU以及肿瘤/鼻咽和肿瘤/腮腺的比值差异均无统计学意义；仅99mTc组的肿瘤/神经丛比值显著高于MIBI组（p<0.05）。总之，我们的数据表明，注射后10分钟脑肿瘤的MIBI闪烁显像相对于传统的99mTc-高锝酸盐脑扫描并未显示出额外的视觉信息，此外，示踪剂滞留主要反映血脑屏障损伤。
