Radionuclide assessment of blood-brain barrier disruption performed for chemotherapy of high grade malignant brain gliomas.

Compared to the conventional mode of chemotherapy of malignant brain gliomas following surgery and radiation therapy, chemotherapy after transient disruption of the blood-brain barrier coupled with intraarterial administration of methotrexate improved median survival from 12-14 to 22 months in our experience. Technetium-99m-DTPA brain scintigraphy played a unique and important role in the documentation of optimum blood-brain barrier disruption. Patients with excellent clinical outcome had significantly (P less than 0.0005) better blood-brain barrier disruption than patients with poor outcome. The results indicate that the clinical outcome is related to the degree of blood-brain barrier disruption.