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Pentavalent technetium-99m-dimercaptosuccinic acid [Tc-99m (V) DMSA] brain SPECT: does it have a place in predicting survival in patients with glioblastoma multiforme?

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Abstract

Pentavalent technetium-99m dimercaptosuccinic acid (Tc-99m (V) DMSA) is reported as a useful tool for detection of residual or recurrent gliomas. We aimed to investigate the prognostic value of Tc-99m (V) DMSA brain SPECT in patients with glioblastoma multiforme (GBM). 40 patients [21 males and 19 females; mean age 48.6 ± 12.2 years] with GBM were included. Tc-99m (V) DMSA brain SPECT was done after surgery and before onset of radiation therapy or chemotherapy (Baseline study), at 4–6 weeks and at 6 months as a follow-up after therapy. The end point of the study was clinical follow-up for 2 years and/or death. 4–6 weeks after therapy, 40 and 60 % had negative and positive Tc-99m (V) DMSA for viable tumor tissues respectively (P = 0.09). At 6 months follow-up, 62.5 % of (V) DMSA negative patients and 12.5 % of the positive subjects were responders (P = 0.001). The median over-all survival (OS) of all patients was 12.3 month [range 5–24 month]. Patients with positive (V) DMSA had worse survival (8.87 month) compared to the negative ones (16.67 month) (P = 0.0001). Multivariate Cox regression analysis showed that Tc-99m (V) DMSA brain SPECT studies at 4–6 weeks and 6-months follow-up were independent prognostic factors for survival [OR 1.069; 95 % CI 1.417–2.174; P = 0.03 and OR 1.055; 95 % CI 0.821–1.186; P = 0.01 respectively]. Stratification of tumors into risk groups based on prognostic parameters may improve outcome by altering or intensifying treatment methods. Technetium-99m dimercaptosuccinic acid brain SPECT may have an additional prognostic role in patients with GBM which needs further evaluation in larger future series.

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Acknowledgments

The authors thank Dr. Zeinab Nawito and Medical student Mariam Amr for helpful contributions in the finalization of this work regarding grammatical aspects.

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Authors and Affiliations

  1. Nuclear Medicine Department, Faculty of Medicine, Cairo University, 32, Soliman Abaza St. Al-Mohandeseen, Giza, Egypt

    Amr Amin & A. Badwey

  2. Oncology Department, Faculty of Medicine, Cairo University, Giza, Egypt

    M. Mustafa, E. Abd El-Hadi, A. Monier & E. Saad

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  1. Amr Amin
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  2. M. Mustafa
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  3. E. Abd El-Hadi
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  4. A. Monier
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  5. A. Badwey
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  6. E. Saad
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Correspondence to Amr Amin.

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Amin, A., Mustafa, M., Abd El-Hadi, E. et al. 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 121, 303–309 (2015). https://doi.org/10.1007/s11060-014-1633-9

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  • DOI: https://doi.org/10.1007/s11060-014-1633-9

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