Department of Neurosurgery, University Hospital of Ioannina, Ioannina, Greece.
J Nucl Med. 2010 Dec;51(12):1923-6. doi: 10.2967/jnumed.110.080929. Epub 2010 Nov 15.
(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.
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.
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.
(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.
（99m）Tc-四氮茂脑 SPECT 已被报道为评估神经胶质瘤增殖的有用工具。在本研究中，我们旨在研究（99m）Tc-四氮茂脑 SPECT 在多形性胶质母细胞瘤患者中的预后价值。
我们前瞻性研究了 18 名接受多形性胶质母细胞瘤手术的患者（男 13 例，女 5 例；平均年龄 ± 标准差，60.8 ± 7.79 岁）。所有患者均行术前（99m）Tc-四氮茂脑 SPECT，SPECT 后一周内进行手术切除。所有患者均接受术后放疗和化疗。
通过计算病变与正常（L/N）（99m）Tc-四氮茂摄取比值，我们发现 L/N 比值大于 4.7 的患者的生存率明显低于 L/N 比值为 4.7 或更低的患者。此外，Karnofsky 表现评分大于 90 的患者的生存率显著提高。尽管年龄小于 60 岁且接近全切除肿瘤的患者存活时间更长，但差异无统计学意义。在多变量分析中，（99m）Tc-四氮茂摄取和 Karnofsky 表现评分被确定为具有独立预后能力的因素。
（99m）Tc-四氮茂脑 SPECT 可能是多形性胶质母细胞瘤患者的独立预后因素。需要进一步的大型研究来验证这些结果。
