الفهرس | Only 14 pages are availabe for public view |
Abstract Accurate diagnosis of recurrent or residual brain tumors after therapy and differentiate it from post-radiation necrosis are very important as progressive radiation necrosis may require conservative measures, while recurrent tumor may need repeated surgery or adjuvant therapy in order to improve the quality of life and survival rate. CT and MRI have been considered the primary imaging modalities due to their superior anatomical resolution. However, CT and MRI some times had difficulties in distinguishing post radiation gliosis from recurrent tumour growth. Radionuclide imaging with SPECT TI-201, 99mTc-sestaMIBI and 99mTc-tetrofosmine are used for the assessment of brain tumors response to therapy to differentiate between residual or recurrent tumor from post-therapeutic changes. The present study was held to evaluate the role of SPECT 99mTc-sestaMIBI brain imaging qualitatively and quantitatively in the assessment of primary brain tumors following therapy to differentiate residual or recurrent tumors from post radiation changes. Among the 48 patients that participated in the study 22 were females (46%) and 26 were males (54%). Their ages ranged between 9 and 62 years with a mean age 35. 5± 13.05. 20 patients had high-grade gliomas (42%), 15 patients had glioblastoma multiformes (31%) and 13 patients had low- grade gliomas (27%). The majority of the lesions were seen in the parietal (29%) and frontal (21%) regions. The majority of patients 42% underwent near total excision, 34% underwent partial excision and 27% were only biopsied. All patients received radiotherapy and only 5 patients received chemotherapy as a second line treatment. All patients included in our study subjected to proper history taking, full clinical examination, anatomical imaging (CT) and brain SPECT using 99mTc-sestaMIBI. 44 out of the initial 48 patients shared in the follow-up and all of them subjected to post-therapy SPECT 99mTc-sestaMIBI and CT. Those patients subjected to qualitative assessment and only 24 patients of them subjected to quantitative assessment. In our study according to the clinical follow-up patients were classified into three group; improved, deteriorated and stationary. When we compared the result of clinical follow-up with that of SPECT 99mTc-sestaMIBI we found that apart from the 5 false negative results and the false positive one, the rest of results were matched with the clinical follow-up. Our results succeeded to emphasize the role of SPECT 99mTc-sestaMIBI brain imaging as a promising modality in the follow-up of patients with primary brain tumors and moreover in the prediction of treatment outcome. |