Recurrent brain tumor or radiation necrosis? Seven histologically verified cases investigated by MRI and Tc99 Sesta MIBI-SPECT

[No Value] Milanesi, M. G. Bruzzone, L. Farina, A. Erbetta, A. Pozzi, A. Silvani, B. Polio, L. Maffioli, M. Savoiardo

Research output: Contribution to journalArticle

Abstract

Differential diagnosis between focal pseudotumoral radiation necrosis and tumor recurrence is often difficult and critical in treatment strategies planning. Seven patients ( 3 glioblastomas, 2 astrocytomas, 1 oligoastrocytoma, 1 oligodendroglioma) treated with surgery, radio- and chemotherapy, have been investigated with MRI and Tc99 Sesta MIBI-SPECT immediately before second surgery. MRI suggested recurrency in 6 cases, tumor and associated radionecrosis in 1 case. SPECT was positive for tumor recurrence in 6 cases and suggested radionecrosis in 1 case. Histological examination demonstrated tumor recurrence in 4 cases in agreement with MRI but not with SPECT because of the presence of a false negative, tumor and radionecrosis in 2 cases, only radionecrosis in 1 case which had not been identified by SPECT and had been considered to harbor both tumor and radionecrosis at MRI. The present results suggest that SPECT may have the drawback of false negative and false positive cases ; Ihese conflicting results may be explained with the small size of the lesion and the vicinity to the choroid plexus. However, pathological examination may also be false and misleading because of insufficient sampling when removal of the lesion is partial. The use of PET and MR Spectroscopy in association with imaging techniques may be necessary to obtain a greater diagnostic sensitivity.

Original languageEnglish
Pages (from-to)41
Number of pages1
JournalItalian Journal of Neurological Sciences
Volume18
Issue number4
Publication statusPublished - 1997

ASJC Scopus subject areas

  • Neuroscience(all)
  • Clinical Neurology

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