RT Journal Article
SR Electronic
T1 Correlation Between Postoperative 3-[<sup>123</sup>I]Iodo-<span class="sc">l</span>-α-Methyltyrosine Uptake and Survival in Patients with Gliomas
JF Journal of Nuclear Medicine
JO J Nucl Med
FD Society of Nuclear Medicine
SP 1144
OP 1150
VO 42
IS 8
A1 Wolfgang A. Weber
A1 Susanne Dick
A1 Guenther Reidl
A1 Brigitte Dzewas
A1 Raymonde Busch
A1 Horst-Jürgen Feldmann
A1 Michael Molls
A1 Christianto B. Lumenta
A1 Markus Schwaiger
A1 Anca L. Grosu
YR 2001
UL http://jnm.snmjournals.org/content/42/8/1144.abstract
AB The aim of this study was to evaluate the prognostic value of SPECT imaging using the amino acid analog 3-[123I]iodo-l-α-methyltyrosine (IMT) in patients with gliomas. Methods: One hundred fourteen consecutive patients with newly diagnosed gliomas were examined by IMT SPECT (low-grade glioma, n = 12; anaplastic astrocytoma or oligodendroglioma, n = 46; glioblastoma, n = 56). Seventy-one of these patients had undergone tumor resection 4–6 wk before SPECT imaging (group A). Forty-three patients with unresectable tumors were examined after stereotactic biopsy (group B). IMT uptake at the site of the tumor was assessed visually and quantified relative to a contralateral reference region (IMT uptake ratio). After IMT SPECT, all patients were treated with conformal radiotherapy. The median follow-up time was 27 mo. Results: In group A, focal IMT uptake at the resection site was visible in 52 of 71 patients (73%). Median survival was only 13 mo in these patients, whereas median survival was reached in patients without focal IMT uptake (P = 0.02). Furthermore, the intensity of IMT uptake significantly correlated with survival: patients with an IMT uptake ratio &gt; 1.7 were at a 4.6 times higher risk of death than were patients with a lower IMT uptake (P &lt; 0.001). The IMT uptake ratio remained a significant prognostic factor when age and grading were included in a multivariate model. In contrast, IMT uptake did not correlate with survival in group B (P = 0.95). Conclusion: In patients with unresectable high-grade gliomas, IMT uptake appears not to correlate with the biologic aggressiveness of tumor cells. Nevertheless, the clear association between focal IMT uptake after tumor resection and poor survival suggests that IMT is a specific marker for residual tumor tissue. Therefore, IMT SPECT is expected to become a valuable tool for the planning and monitoring of local therapeutic modalities.