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Technetium-99m-d, 1-Hexamethylpropyleneamine Oxime (HMPAO) Uptake and Glutathione Content in Brain Tumors

Clinic of Neurology, Department of Biochemical Pharmacology, and Clinic of Neurosurgery, University of Vienna, Vienna, Austria

Correspondence: For reprints contact: Erhard Suess, MD, Clinic of Neurology, University of Vienna, Lazarettgasse 14, A-1090 Vienna, Austria.

ABSTRACT

Technetium-d, HMPAO SPECT was performed in 70 patients suffering from intracerebral tumors of various histologic types (glioma n = 30, meningeoma n = 19, metastases n = 10, angioma n = 3, neuroma n = 2, lymphoma n = 2, neurocytoma n = 1, epidermoid n = 1, gliosis n = 1, cholesteatoma n = 1). Tumor classification was histologically verified in all subjects except in two cases with inoperable angiomas. SPECT was performed under resting state conditions with a dual-head rotating camera (SIEMENS ZLC 37) following intravenous injection of 18–25 mCi ^99mTc-d, 1-HMPAO. Regional tracer deposit was expressed in terms of a cerebellar index (CBI). Significantly higher regional HMPAO uptake was found in meningeomas when compared with gliomas of different malignancy (ANOVA p < 0.05). Within gliomas, regional uptake increased with malignancy (n.s.). In 23 patients, a total of 32 tumor specimens were obtained for histochemical analysis of glutathione (GSH) content using high-pressure liquid chromatography. A significant correlation (least square method, p < 0.001) between CBIs and GSH values was found, supporting the hypothesis that GSH is the predominant factor for the conversion of the lipophilic complex to hydrophilic derivates.

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