HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Kuwert, T. Articles by Schober, O. Search for Related Content PubMed PubMed Citation Articles by Kuwert, T. Articles by Schober, O.

Diagnosis of Recurrent Glioma with SPECT and Iodine-123--Methyl Tyrosine

Departments of Nuclear Medicine and Neurosurgery, Westfälische Wilhelms-Universität, Münster, Germany

Correspondence: For correspondence or reprints contact: Torsten Kuwert, MD, Department of Nuclear Medicine, Westfälische Wilhelms-Universität Münster, Albert-Schweitzer-Strasse 33, 48129 Münster, Germany.

ABSTRACT

Iodine-123--methyl tyrosine (IMT) allows the investigation of amino acid transport rate in brain neoplasms. It was the aim of this study to evaluate the potential of IMT-SPECT to diagnose the recurrence of gliomas after primary therapy. Methods: Using a triple-headed SPECT camera, the cerebral uptake of IMT was determined in 27 patients 22 mo, on average, after surgical removal of a primary brain tumor. Eighteen patients had suffered from high-grade gliomas, and nine had suffered from low-grade tumors. Four patients were examined before and after surgical revision of a presumed tumor recurrence. A total of 31 studies were evaluated. The final diagnosis was based on prospective clinicopathological follow-up. Recurrence was diagnosed in 23 cases, with marked clinical deterioration occurring 3.1 mo, on average, after SPECT, and was confirmed by histopathology in 14 instances. Eight cases were free of recurrence, as evidenced by inconspicuous clinical follow-up, ranging from 6 mo to 17 mo after SPECT in seven cases, and by clinical course and histopathology in the remaining subject. Results: Patients with recurrence had significantly higher ratios of IMT uptake in the tumor area to that in a background region than did patients without recurrence (2.27 ± 0.59 compared to 1.47 ± 0.29; p < 0.002). The best cutoff level of the IMT uptake ratio in the differentiation between recurrence and benign posttherapeutic lesion was 1.8. Using this study-specific discrimination threshold, the sensitivity and specificity of IMT-SPECT for detecting glioma recurrence were 18 of 23 (78%) and 8 of 8 (100%), respectively. The area under the binormal receiver operating characteristic curve, fitted to the data, was 0.90 ± 0.06. Conclusion: Iodine-123--methyl tyrosine-SPECT is a promising new tool in the follow-up of patients with gliomas after primary therapy.

Key Words: SPECT • iodine-123--methyl tyrosine • amino acids • brain neoplasms • gliomas

This article has been cited by other articles:

				C. Walker, D. G. du Plessis, D. Fildes, B. Haylock, D. Husband, M. D. Jenkinson, K. A. Joyce, J. Broome, K. Kopitski, J. Prosser, et al. Correlation of Molecular Genetics with Molecular and Morphological Imaging in Gliomas with an Oligodendroglial Component Clin. Cancer Res., November 1, 2004; 10(21): 7182 - 7191. [Abstract] [Full Text] [PDF]

				M. Henze, A. Mohammed, H. P. Schlemmer, K. K. Herfarth, S. Hoffner, S. Haufe, W. Mier, M. Eisenhut, J. Debus, and U. Haberkorn PET and SPECT for Detection of Tumor Progression in Irradiated Low-Grade Astrocytoma: A Receiver-Operating-Characteristic Analysis J. Nucl. Med., April 1, 2004; 45(4): 579 - 586. [Abstract] [Full Text] [PDF]

				B. Riemann, K. Papke, N. Hoess, T. Kuwert, M. Weckesser, P. Matheja, H. Wassmann, W. Heindel, and O. Schober Noninvasive Grading of Untreated Gliomas: A Comparative Study of MR Imaging and 3-(Iodine 123)-L-{alpha}-methyltyrosine SPECT Radiology, November 1, 2002; 225(2): 567 - 574. [Abstract] [Full Text] [PDF]

				S. Samnick, J. B. Bader, D. Hellwig, J. R. Moringlane, C. Alexander, B. F.M. Romeike, W. Feiden, and C.-M. Kirsch Clinical Value of Iodine-123-Alpha-Methyl-L-Tyrosine Single-Photon Emission Tomography in the Differential Diagnosis of Recurrent Brain Tumor in Patients Pretreated for Glioma at Follow-Up J. Clin. Oncol., January 15, 2002; 20(2): 396 - 404. [Abstract] [Full Text] [PDF]

				W. A. Weber, S. Dick, G. Reidl, B. Dzewas, R. Busch, H.-J. Feldmann, M. Molls, C. B. Lumenta, M. Schwaiger, and A. L. Grosu Correlation Between Postoperative 3-[123I]Iodo-L-{alpha}-Methyltyrosine Uptake and Survival in Patients with Gliomas J. Nucl. Med., August 1, 2001; 42(8): 1144 - 1150. [Abstract] [Full Text] [PDF]

				E. E. Camargo Brain SPECT in Neurology and Psychiatry J. Nucl. Med., April 1, 2001; 42(4): 611 - 623. [Abstract] [Full Text]

				P. L. Jager, W. Vaalburg, J. Pruim, E. G.E. de Vries, K.-J. Langen, and D. A. Piers Radiolabeled Amino Acids: Basic Aspects and Clinical Applications in Oncology J. Nucl. Med., March 1, 2001; 42(3): 432 - 445. [Abstract] [Full Text]