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The value of quantitative pentavalent 99mTc-dimercaptosuccinic acid scan in predicting progression-free survival and overall survival in patients with glioblastoma multiforme

Published online by Cambridge University Press:  14 April 2020

Ehab Saad*
Affiliation:
Department of Clinical Oncology, Cairo University, Kasr Alaini, Cairo, Egypt
Ahmed Badawy
Affiliation:
Department of Clinical Oncology, Cairo University, Kasr Alaini, Cairo, Egypt
Mahasen Abougabal
Affiliation:
Department of Clinical Oncology, Cairo University, Kasr Alaini, Cairo, Egypt
Ahmed Kandeel
Affiliation:
Department of Clinical Oncology, Cairo University, Kasr Alaini, Cairo, Egypt
*
Author for correspondence: Ehab Saad, Department of Clinical Oncology, Cairo University, Kasr Alaini, Cairo, Egypt. E-mail: [email protected]

Abstract

Aim:

Glioblastoma multiforme (GBM) is the commonest and the most aggressive primary brain tumour. Pentavalent 99mTc-dimercaptosuccinic acid (99mTc (V)-DMSA) has been found to be a tumour-seeking agent. Pre-radiotherapy 99mTc (V)-DMSA positive scan was found to be significantly correlated with poor progression-free survival (PFS) and overall survival (OS). This study aims at evaluating the impact of quantitative 99mTc (V)-DMSA tumour uptake before and after radiotherapy on PFS and OS in patients with GBM.

Methods:

A prospective study included 40 patients with GBM. Single-photon emission computed tomography studies were done before and after adjuvant radiotherapy and were qualitatively and quantitatively evaluated. The retention index (RI) of the viable tumour was correlated with PFS and OS.

Results:

The qualitative enhancement of 99mTc (V)-DMSA uptake either positive or negative was significantly correlated with PFS at both early and late images (p-values 0·04 and 0·026, respectively) and OS only in the late image (p-value 0·036). The calculated ion/non-lesion ratios at late images were statistically correlated with PFS and OS (p-values 0·021 and 0·025, respectively). The baseline RI had significant correlation with PFS only (p-value 0·01).

Conclusion:

The degree of 99mTc (V)-DMSA scan positivity is a poor prognostic factor for PFS and OS in GBM patients.

Type
Original Article
Copyright
© The Author(s), 2020. Published by Cambridge University Press

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References

Jemal, A, Siegel, R, Ward, E, Murray, T, Xu, J, Thun, MJ. Cancer statistics, 2007. CA Cancer J Clin 2007; 57 (1): 4366.CrossRefGoogle ScholarPubMed
Norden, AD, Wen, PY. Glioma therapy in adults. Neurologist 2006; 12 (6): 279292.CrossRefGoogle ScholarPubMed
Buckner, JC, Brown, PD, O’Neill, BP, Meyer, FB, Wetmore, CJ, Uhm, JH. Central nervous system tumors. Mayo Clin Proc 2007; 82 (10): 12711286.CrossRefGoogle ScholarPubMed
Ohgaki, H, Kleihues, P. Population-based studies on incidence, survival rates, and genetic alterations in astrocytic and oligodendroglial gliomas. J Neuropathol Exp Neurol 2005; 64 (6): 479489.CrossRefGoogle ScholarPubMed
Mitchell, P, Ellison, DW, Mendelow, AD. Surgery for malignant gliomas: mechanistic reasoning and slippery statistics. Lancet Neurol 2005; 4 (7): 413422.CrossRefGoogle ScholarPubMed
Chen, W. Clinical applications of PET in brain tumors. J Nucl Med 2007; 48 (9): 14681481.CrossRefGoogle ScholarPubMed
Ohta, H, Yamamoto, K, Endo, K et al. A new imaging agent for medullary carcinoma of the thyroid. J Nucl Med 1984; 25 (3): 323325.Google ScholarPubMed
Clarke, SEM, Lazarus, CR, Wraight, P, Sampson, C, Maisey, MN. Pentavalent [99mTc]DMSA,[131I]MIBG, and [99mTc]MDP-an evaluation of three imaging techniques in patients with medullary carcinoma of the thyroid. J Nucl Med 1988; 29 (1): 3338.Google Scholar
Kiratli, H, Kiratli, , Ercan, MT. Scintigraphic evaluation of tumors metastatic to the choroid using Technetium-99m(V)-Dimercaptosuccinic acid. Jpn J Ophthalmol 1998; 42 (1): 6065.CrossRefGoogle ScholarPubMed
Amin, A, Mustafa, M, Abd El-Hadi, E, Monier, A, Badwey, A, Saad, E. Pentavalent technetium-99m-dimercaptosuccinic acid [Tc-99m (V) DMSA] brain SPECT: does it have a place in predicting survival in patients with glioblastoma multiforme? J Neurooncol 2015; 121 (2): 303309.CrossRefGoogle ScholarPubMed
Oken, MM, Creech, RH, Tormey, DC et al. Toxicity and response criteria of the Eastern Cooperative Oncology Group. Am J Clin Oncol 1982; 5 (6): 649656.CrossRefGoogle ScholarPubMed
Stark, AM, Van De Bergh, J, Hedderich, J, Mehdorn, HM, Nabavi, A. Glioblastoma: clinical characteristics, prognostic factors and survival in 492 patients. Clin Neurol Neurosurg 2012; 114 (7): 840845.CrossRefGoogle ScholarPubMed
Ma, X, Lv, Y, Liu, J et al. Survival analysis of 205 patients with glioblastoma multiforme: clinical characteristics, treatment and prognosis in China. J Clin Neurosci 2009; 16 (12): 15951598.CrossRefGoogle ScholarPubMed
Amin, A, Moustafa, H, Ahmed, E, El-Toukhy, M. Glioma residual or recurrence versus radiation necrosis: accuracy of Pentavalent technetium-99m-dimercaptosuccinic acid [Tc-99m (V) DMSA] brain SPECT compared to proton magnetic resonance spectroscopy (1H-MRS): initial results. J Neurooncol 2012; 106 (3): 579587.CrossRefGoogle ScholarPubMed
Deltuva, V, Bunevicius, A, Jurkiene, N, Kulakiene, I, Tamasauskas, A. Perioperative single photon emission computed tomography in predicting survival of malignant glioma patients. Oncol Lett 2012; 4 (4): 739744.CrossRefGoogle ScholarPubMed
Bénard, F, Romsa, J, Hustinx, R. Imaging gliomas with positron emission tomography and single-photon emission computed tomography. Semin Nucl Med 2003; 33 (2): 148162.CrossRefGoogle ScholarPubMed
Soler, C, Beauchesne, P, Maatougui, K et al. Technetium-99m sestamibi brain single-photon emission tomography for detection of recurrent gliomas after radiation therapy. Eur J Nucl Med 1998; 25 (12): 16491657.CrossRefGoogle ScholarPubMed
Alexiou, GA, Tsiouris, S, Kyritsis, AP et al. The value of 99mTc-tetrofosmin brain SPECT in predicting survival in patients with glioblastoma multiforme. J Nucl Med 2010; 51 (12): 19231926.CrossRefGoogle ScholarPubMed