Japanese
Title99mTc-MIBIによる脳腫瘍の評価 : 201Tlとの比較および治療効果との関連について
Subtitle原著
Authors長町茂樹*, 陣之内正史*, 大西隆*, Leo G.FLORES II*, 小玉隆男*, 中原浩*, 二見繁美*, 田村正三*, 渡邊克司*, 横上聖貴**, 河野寛一**, 脇坂信一郎**
Authors(kana)
Organization*宮崎医科大学放射線医学教室, **宮崎医科大学脳外科学教室
Journal核医学
Volume35
Number3
Page121-130
Year/Month1998/3
Article原著
Publisher日本核医学会
Abstract「要旨」脳腫瘍患者31例(Glioblastoma 11例, Low grade astrocytoma 4例, Anaplastic astrocytoma 4例, Metastasis 5例, 髄膜腫3例, 血管芽腫2例, 松果体腫1例, 脊索腫1例)を対象に, 99mTc-MIBI(MIBI)の描出能を201Tl(Tl)と比較し, 病理組織型別に検討した. 定量的指標として早期, 後期像にて腫瘍部と健常部の平均 count 比より Early ratio (ER), Delayed ratio (DR), Retention index (RI) を算出し, 各組織群間で比較した. またACNU, Cisplatine 動注治療を受けた Glioblastoma (GBM) 患者を対象に, MIBIの集積程度と予後との関連についても検討した. 全体の陽性描出率はMIBIでは早期像で90.3%, 後期像で77.4%でありTlの描出率(90.3%および80.6%)とほぼ同等であった. 病理組織型別ではMIBI, Tlともに早期, 後期像でGBM, Anaplastic astrocytoma, Metastasis (Meta) では100%であり Low grade type では25%であった. 他の髄膜腫, 血管芽腫, 松果体腫, 脊索腫に関しては両薬剤とも早期像では全例に集積を認めた. 後期像で洗い出しのみられたものは髄膜腫3例中MIBIの2例, Tlの1例と血管芽腫2例であった. 定量指標のER, DR, RIは両薬剤ともGBM, Meta, Anaplastic astrocytoma の3群間で有意な差は認められなかったが, GBMのER, DRは Anaplastic astrocytoma と比較して高い傾向が認められた. Glioma において, MIBIはTl同様悪性度の評価に有用である可能性が示唆された. なおER, DRの値は, いずれもMIBIの方が高く, コントラストの良い画像が得られた. GBM患者ではMIBIの強集積が認められたが, 1例を除いて検査後半年以内に全例死亡しており, GBMでACNU, Cisplatine を用いる場合, MIBIの集積は良好な治療効果を予測させるものではないと思われた.
Practice臨床医学：一般
Keywords99mTc-MIBI, 201Tl-chloride, Brain tumor, Predictivity of anticancer therapy
English
TitleEvaluation of Brain Tumor by 99mTc-MIBI : Comparison Study with 201Tl and Predictivity of Therapeutic Effect
SubtitleOriginal Articles
AuthorsShigeki NAGAMACHI*, Seishi JINNOUCHI*, Leo G.FLORES II*, Takao KODAMA*, Takashi OHNISHI*, Hiroshi NAKAHARA*, Shigemi FUTAMI*, Shozo TAMURA*, Katsushi WATANABE*, Kiyotaka YOKOGAMI**, Hirokazu KAWANO**, Shinnichiro WAKISAKA**
Authors(kana)
Organization*Department of Radiology, Miyazaki Medical College, **Department of Neurosurgery, Miyazaki Medical College
JournalThe Japanese Journal of nuclear medicine
Volume35
Number3
Page121-130
Year/Month1998/3
ArticleOriginal article
PublisherTHE JAPANESE SOCIETY OF NUCLEAR MEDICINE
AbstractWe compared the detectability of 99mTc-MIBI and 201Tl-chloride for brain tumor in relationship with histopathology. We also evaluated correlation between therapeutic effect using ACNU, Cisplatine and the degree of MIBI tumor uptake. The subjects were 31 brain tumor histologically confirmed by operation or biopsy. Dual-isotope SPECT technique was performed at both 20 min and 180 min after tracer injection. A tumor to normal lung ratio on both early (ER) and delayed image (DR) and retention index (RI) were calculated. The positive rates of 99mTc-MIBI (90.3% and 77.4%) were comparable to that of 201Tl (90.3% and 80.6%). In the relationship with histopathology, both MIBI and Tl accumulated in 100% of glioblastoma (GBM), metastasis (meta), anaplastic astrocytoma and 25% of low grade astrocytoma on both early and delayed images. On semiquantitative analysis, there were no statistical significance among GBM, meta and anaplastic astrocytoma of ER, DR, RI in the both radiopharmaceuticals. However, both ER and DR in GBM tended to be higher than those of anaplastic astrocytoma. In spite of intense MIBI uptake, GBM patients died within six months except one patient. We concluded that MIBI can be helpful in detecting brain tumor as Tl. MIBI also might be useful in estimating the degree of malignancy in glioma. However intense MIBI uptake did not mean favorable therapeutic effect in patients with GBM treated with ACNU and Cisplatine.
PracticeClinical medicine
Keywords99mTc-MIBI, 201Tl-chloride, Brain tumor, Predictivity of anticancer therapy

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