Indium-111-pentetreotide imaging in intra-axial brain tumors: comparison with thallium-201 SPECT and MRI.
Highly undifferentiated glial tumors do not express somatostatin receptors (SSR) in contrast to low-grade astrocytomas which contain SSR. To differentiate a malignant glioma from a low-grade astrocytoma and to distinguish an SSR-positive intra-axial brain tumor from an SSR negative one, 111In-pentetreotide brain SPECT was prospectively undertaken. METHODS: Eight patients with intra-axial brain tumors (three glioblastoma multiforme, one low-grade astrocytoma, one lymphoma, one medulloblastoma, one neurocytoma and one metastatic tumor) were studied. Thallium-201 and 111In-pentetreotide brain SPECT were performed with a 3- to 4-day interval before surgery. The SPECT findings were compared with those of Gd-enhanced MRI. RESULTS: Increased uptake of 111In-pentetreotide was observed in all of the patients with glioblastoma multiforme (Grade in two and Grade + in one) despite lack of SSR. Low-grade astrocytoma exhibited minimal uptake of 111In-pentetreotide (Grade +). Remaining tumors had intense uptake of 111In-pentetreotide. Thallium-201 SPECT showed similar findings to those of 111In-pentetreotide scintigraphy except in two patients with glioblastoma multiforme: One with 201TL negative scan showed increased uptake of 111In-pentetreotide and the other showed increased thallium uptake but minimal uptake of 111In-pentetreotide. The uptake pattern of both 201Tl and 111In-pentetreotide appeared to correlate with Gd-enhanced MRI. CONCLUSION: Indium-111-pentetreotide scintigraphy is sensitive in the detection of intra-axial brain tumors; however, it has no role in assessing the tumor grading and in the definition of the receptor profile.[1]References
- Indium-111-pentetreotide imaging in intra-axial brain tumors: comparison with thallium-201 SPECT and MRI. Lee, J.D., Kim, D.I., Lee, J.T., Chang, J.W., Park, C.Y. J. Nucl. Med. (1995) [Pubmed]
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