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BioMed Research International
Volume 2014 (2014), Article ID 684383, 6 pages
http://dx.doi.org/10.1155/2014/684383
Research Article

Assessing Response Using -MIBI Early after Interstitial Chemotherapy with Carmustine-Loaded Polymers in Glioblastoma Multiforme: Preliminary Results

1Nuclear Medicine Service, Department of Medicine (DIMED), University Hospital, 35128 Padova, Italy
2Department of Neurosurgery, University Hospital, 35128 Padova, Italy
3Department of Medical Oncology 1, IOV, IRCCS, Venetian Oncology Institute, 35128 Padova, Italy
4Surgical Pathology & Cytopathology Unit, Department of Medicine (DIMED), University Hospital, 35128 Padova, Italy
5Neuroradiology Unit, University Hospital, 35128 Padova, Italy
6Biostatistics, Epidemiology and Public Health Unit, Department of Cardiac, Thoracic and Vascular Sciences, University Hospital, 35128 Padova, Italy

Received 13 February 2014; Accepted 4 March 2014; Published 27 March 2014

Academic Editor: Anna Luisa Di Stefano

Copyright © 2014 D. Cecchin et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Introduction. Early signs of response after applying wafers of carmustine-loaded polymers (gliadel) are difficult to assess with imaging because of time-related imaging changes. -sestamibi (MIBI) brain single-photon emission tomography (SPET) has reportedly been used to reveal areas of cellularity distinguishing recurrent neoplasm from radionecrosis. Our aim was to explore the role of MIBI SPET in assessing response soon after gliadel application in glioblastoma multiforme (GBM). Methods. We retrospectively reviewed the charts on 28 consecutive patients with a radiological diagnosis of GBM who underwent MIBI SPET/CT before surgery (with intracavitary gliadel placement in 17 patients), soon after surgery, and at 4 months. The area of uptake was selected using a volume of interest that was then mirrored contralaterally to obtain a semiquantitative ratio. Results. After adjusting for ratio at the baseline, the effect of treatment (gliadel versus non-gliadel) was not statistically significant. Soon after surgery, however, 100% of patients treated with gliadel had a decreased ratio, as opposed to 62.5% of patients in the non-gliadel group . The difference between ratios of patients with radical versus partial resection reached statistical significance by a small margin . Conclusions. These data seem to suggest that the MIBI ratio could be a valuable tool for monitoring the effect of gliadel early after surgery.