Journal of Postgraduate Medicine Medknow Publications and Staff Society of Seth GS Medical College and KEM Hospital, Mumbai, India ISSN: 0022-3859 EISSN: 0972-2823 Vol. 55, Num. 3, 2009, pp. 159-159

Journal of Postgraduate Medicine, Vol. 55, No. 3, July-September, 2009, pp. 159

Guest Editorial

Single-photon emission computed tomography for the characterization of intracranial lesions

Alexiou GA

Department of Neurosurgery, University Hospital of Ioannina, Ioannina, Greece

Correspondence Address: Alexiou GA, Department of Neurosurgery, University Hospital of Ioannina, Ioannina, Greece
alexiougr@gmail.com

Code Number: jp09049

PMID: 19884737

DOI: 10.4103/0022-3859.57385

The present study has provided further evidence for the importance of brain single-photon emission computed tomography (SPECT) in the assessment of intracranial lesions.^[1] Glucoheptonate was shown to be a suitable radiotracer with high sensitivity and specificity for the differentiation of neoplastic from non-neoplastic intracerebral lesions. This differentiation is of paramount importance for the patients management and prognosis.

The neuromorphologic imaging provided by magnetic resonance imaging (MRI) and computed tomography (CT) faces inherent limitations for the metabolic assessment of intracranial lesions. The latest MR techniques such as MR perfusion, diffusion and spectroscopy are promising but further studies are needed. Nuclear medicine techniques, namely SPECT and positron emission tomography (PET) have the ability to evaluate the metabolic status of an intracranial lesion. Nevertheless, PET is not widely available and is expensive. SPECT has been used as an alternative imaging technique. Various radiotracers have been evaluated and apart from glucoheptonate, 99mTc-hexakis-2-methoxy isobutyl isonitrile and 99mTc-Tetrofosmin have proved to be suitable for brain tumor imaging. ^[2],[3],[4] SPECT imaging can provide important information for the differentiation of glioma recurrence from radiation necrosis, neoplastic from non-neoplastic intracerebral hemorrhage, evaluation of brain tumor aggressiveness, response to treatment and prognosis. ^{[2],[3],[4],[5],[6],[7]} Overall, there is a need for well-designed, prospective comparative studies between SPECT and PET radiotracers and with the novel MR techniques.

References

1.	Jaiswal S, Barai S, Rajkumar, Gambhir S, Ora M, Mahapatra AK. Evaluation of intracranial space-occupying lesion with Tc99m-glucoheptonate brain single photon emission computed tomography in treatment-naοve patients. J Postgrad Med 2009;55:180-4.  Back to cited text no. 1  [PUBMED]
2.	Baldari S, Restifo Pecorella G, Cosentino S, Minutoli F. Investigation of brain tumours with (99m)Tc-MIBI SPET. Q J Nucl Med 2002;46:336-45.  Back to cited text no. 2
3.	Alexiou GA, Vartholomatos G, Tsiouris S, Papadopoulos A, Kyritsis AP, Polyzoidis KS, et al. Evaluation of meningioma aggressiveness by (99m)Tc-Tetrofosmin SPECT. Clin Neurol Neurosurg 2008;110:645-8.  Back to cited text no. 3
4.	Alexiou GA, Tsiouris S, Goussia A, Papadopoulos A, Kyritsis AP, Polyzoidis KS, et al. Evaluation of glioma proliferation by 99mTc-Tetrofosmin. Neuro Oncol 2008;10:104-5.  Back to cited text no. 4
5.	Barai S, Bandopadhayaya GP, Julka PK, Malhotra A, Bal CS, Dhanpathi H. Imaging using Tc99m-tetrofosmin for the detection of the recurrence of brain tumour: a comparative study with Tc99m-glucoheptonate. J Postgrad Med 2004;50:89-93.  Back to cited text no. 5  [PUBMED]
6.	Alexiou GA, Bokharhii JA, Kyritsis AP, Polyzoidis KS, Fotopoulos AD. Tc-99m Tetrofosmin SPECT for the differentiation of a cerebellar hemorrhage mimicking a brain metastasis from a renal cell carcinoma. J Neurooncol 2006;78:207-8.  Back to cited text no. 6
7.	Bleichner-Perez S, Le Jeune F, Dubois F, Steinling M. 99mTc-MIBI brain SPECT as an indicator of the chemotherapy response of recurrent, primary brain tumors. Nucl Med Commun 2007;28:888-94.  Back to cited text no. 7

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