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Discordant Technetium-99m-MIBI and Technetium 99m-HMPAO Uptake of Recurrent Occipital Meningioma on Brain SPECT Images

Nuclear Medicine and Radiology Services, Veterans Affairs Medical Center, Lexington, Kentucky
University of Kentucky Medical Center, Lexington, Kentucky

Correspondence: For correspondence or reprints contact: W.J. Shih, MD, Nuclear Medicine Service, VA Medical Center, Lexington, KY 40511.

ABSTRACT

Technetium-99m-HMPAO and ^99mTc-MIBI brain SPECT, MRI, CT and cerebral angiogram were studied in a patient with recurrent occipital meningioma. MRI and CT of the head showed right cerebral hemispheric tumor masses involving parasagittal, temporal and parietoccipital areas. The angiograms showed an intense vascular tumor blush in recurrent mass lesions supplied by the following arteries: the meningeal branch of the right external carotid artery, the right middle cerebral artery, the right anterior cerebral artery and the right posterior cerebral artery. Although demonstrable ^99mTc-MIBI lesions mass exactly corresponded to CT and MRI (T-1) findings, mass lesions exhibited a mismatch between ^99mTc-MIBI (increased uptake)and ^99mTc-HMPAO (absent uptake) brain SPECT images. Technetium-99m-MIBI images, rather than ^99mTc-HMPAO brain SPECT, resulted in the correct pathological diagnosis of recurrent meningioma.

Key Words: technetium-99m-MIBI • technetium-99m-HMPAO • occipital meningioma • SPECT

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