Detection of Relapses of Glial Brain Tumors Using Quantification of Single-Photon Emission Computed Tomography with  99m Tc Technetril and of Perfusion Magnetic Resonance Imaging in Arterial Spin Labelling Mode

Wladimir Yu. Ussov; Ilya S. Karabanov; Stanislav M. Minin; Andrey A. Tulupov; Li YongPing; Zhanat Zh. Anashbaev; Pavel A. Semin; Shan YaMing; N. A. Nikitin; Evgenii S. Polovnikov; Mikhail E. Amelin; Yuri B. Lishmanov; В. Ю. Усов; И. С. Карабанов; С. М. Минин; А. А. Тулупов; Ли Юн-Пин; Ж. Ж. Анашбаев; П. А. Семин; Шан Я-Мин; Н. А. Никитин; Е. С. Половников; М. Е. Амелин; Ю. Б. Лишманов

doi:10.18705/23114495-2026-13-1-92-107

Detection of Relapses of Glial Brain Tumors Using Quantification of Single-Photon Emission Computed Tomography with ^99mTc Technetril and of Perfusion Magnetic Resonance Imaging in Arterial Spin Labelling Mode

https://doi.org/10.18705/23114495-2026-13-1-92-107

EDN: NLBIXH

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Abstract

The aim of the study was to quantify and compare the parameters of cerebral tumor blood flow in neuro-oncological neurosurgical patients with relapse-free course and recurrence of glial low-grade tumors using SPECT-CT with ^99mTc-Technetril as a tumorotropic radiopharmaceutical, and MRI in the arterial spin labelling (ASL) mode. Materials and methods. The study included 23 patients treated 2019-2020 with glial brain tumors (15 with grade 2‒4 anaplasia gliomas and 8 with glioblastomas). Of these, 16 with glial brain tumors (13 — gliomas and 3 — glioblastomas) after radical tumor removal followed by external gamma therapy, and 7 with inoperable formations were examined after chemoradiotherapy, without surgical removal. The patients were divided into groups 1 — with a relapse-free course, 11 people; of those who had a relapse/continued growth, 12 patients (group 2), five of them died during a two-year follow-up. All underwent MRI of the brain (MRI 3.0 T) in ASL mode with calculation of cerebral blood flow in absolute units — as ml/min/100 cm3, as well as SPECT-CT with ^99mTc-Technetril on a gamma camera with the ability to determine standardized uptake values (SUV), with calculation of blood flow in tumor formations (РКрОп_ОФЭКТ), using the method KML (Krivonogov-Minin-Lishmanov), as РКрОпОФЭКТ = СВП99mTc-Технетрил * (МО/Body Weight) * 100, where СВП99mTc-Технетрил is the standardized value of rfp uptake, MO is the minute volume, 100 is the conversion coefficient for representing the result in the usual units “ml/min/100 cm³ of tissue”. Results. ASL MRI and SPECT-CT with ^99mTc-Technetril methods significantly correlate with each other and are interchangeable in terms of the obtained values of blood flow of malignant tumors, both maximum and average in the studied regions. If there is a visual nodular structure in the area of the removed brain tumor, and blood flow anywhere within it is more than 23 ml/min/ 100 cm³, the presence of continued growth or recurrence of a low-grade glial neoplasm is likely. Conclusion. As follows from the presented visual-semiotic and computational data of ASL MRI and SPECT CT with ^99mTc-Technetril, these methods should reasonably be used as widely as possible for early monitoring of the postoperative condition in patients after radical removal of glial low-grade brain tumors. It is advisable to further their comparative and joint study, including in inter-center studies.

Keywords

MRI, SPECT/CT, arterial spin laqbelling, 99mTc-Technetril, paramagnetic contrast enhancement, pharmacokinetics, neuro-oncology, gliomas, meningeomas, brain metastases

About the Authors

Wladimir Yu. Ussov

Academician E.N. Meshalkin National Medical Research Center of the Ministry of Health of the Russia
Russian Federation

Wladimir Yu. Ussov, MD, DSc, Professor, Chief researcher at the department of radiation and instrumental research,

15, Rechkunovskaya str., Novosibirsk, 630055.

Competing Interests: