Nagamachi S, Jinnouchi S, Flores L G, Kodama T, Ohnishi T, Nakahara H, Futami S, Tamura S, Watanabe K, Yokogami K, Kawano H, Wakisaka S
Department of Radiology, Miyazaki Medical College.
Kaku Igaku. 1998 Mar;35(3):121-30.
We compared the detectability of 99mTc-MIBI and 201Tl-chloride for brain tumor in relationship with histopathology. We also evaluated correlation between therapeutic effect using ACNU, Cisplatine and the degree of MIBI tumor uptake. The subjects were 31 brain tumor histologically confirmed by operation or biopsy. Dual-isotope SPECT technique was performed at both 20 min and 180 min after tracer injection. A tumor to normal lung ratio on both early (ER) and delayed image (DR) and retention index (RI) were calculated. The positive rates of 99mTc-MIBI (90.3% and 77.4%) were comparable to that of 201Tl (90.3% and 80.6%). In the relationship with histopathology, both MIBI and Tl accumulated in 100% of glioblastoma (GBM), metastasis (meta), anaplastic astrocytoma and 25% of low grade astrocytoma on both early and delayed images. On semiquantitative analysis, there were no statistical significance among GBM, meta and anaplastic astrocytoma of ER, DR, RI in the both radiopharmaceuticals. However, both ER and DR in GBM tended to be higher than those of anaplastic astrocytoma. In spite of intense MIBI uptake, GBM patients died within six months except one patient. We concluded that MIBI can be helpful in detecting brain tumor as Tl. MIBI also might be useful in estimating the degree of malignancy in glioma. However, intense MIBI uptake did not mean favorable therapeutic effect in patients with GBM treated with ACNU and Cisplatine.
我们比较了99mTc-MIBI和201Tl氯化物对脑肿瘤的检测能力及其与组织病理学的关系。我们还评估了使用阿糖胞苷、顺铂治疗的效果与MIBI肿瘤摄取程度之间的相关性。研究对象为31例经手术或活检组织学确诊的脑肿瘤患者。在注射示踪剂后20分钟和180分钟进行双同位素SPECT检查。计算早期（ER）和延迟图像（DR）上的肿瘤与正常肺组织比值以及滞留指数（RI）。99mTc-MIBI的阳性率（90.3%和77.4%）与201Tl（90.3%和80.6%）相当。在与组织病理学的关系方面，早期和延迟图像上，MIBI和Tl在100%的胶质母细胞瘤（GBM）、转移瘤（meta）、间变性星形细胞瘤以及25%的低级别星形细胞瘤中均有积聚。在半定量分析中，两种放射性药物在GBM、meta和间变性星形细胞瘤的ER、DR、RI之间均无统计学意义。然而，GBM的ER和DR往往高于间变性星形细胞瘤。尽管GBM患者MIBI摄取强烈，但除1例患者外，其余患者均在6个月内死亡。我们得出结论，MIBI在检测脑肿瘤方面与Tl一样有帮助。MIBI在评估胶质瘤的恶性程度方面可能也有用。然而，对于接受阿糖胞苷和顺铂治疗的GBM患者，MIBI摄取强烈并不意味着治疗效果良好。
