1
|
Trakolis L, Petridis AK. Interdisciplinary Therapeutic Approaches to Atypical and Malignant Meningiomas. Cancers (Basel) 2023; 15:4251. [PMID: 37686527 PMCID: PMC10486693 DOI: 10.3390/cancers15174251] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2023] [Revised: 08/09/2023] [Accepted: 08/23/2023] [Indexed: 09/10/2023] Open
Abstract
Meningiomas have the highest incidence among brain tumors. In contrast to benign tumors that constitute the majority of this tumor entity, the treatment of aggressive meningiomas (WHO Grade 2 and 3) is more challenging, requiring gross total removal of the tumor and the affected dura and adjuvant radiotherapy. Sometimes the location and/or the configuration of the tumor do not favor radical surgical resection without endangering the patient's clinical condition after surgery and pharmacological therapy has, until now, not been proven to be a reliable alternative. Discussion: In this narrative review, we discuss the current literature with respect to the management of meningiomas, discussing the importance of the grade of resection in the overall prognosis of the patient and in the planning of adjuvant therapy. Conclusions: According to the location and size of the tumor, radical resection should be taken into consideration. In patients with aggressive meningiomas, adjuvant radiotherapy should be performed after surgery. In cases of skull base meningiomas, a maximal, though safe, resection should take place before adjuvant therapy. An interdisciplinary approach is beneficial for patients with primary or recurrent meningioma.
Collapse
Affiliation(s)
- Leonidas Trakolis
- Department of Neurosurgery, Agios Loukas Clinic Thessaloniki, 55236 Thessaloniki, Greece;
| | | |
Collapse
|
2
|
Filis P, Alexiou GA, Zigouris A, Sioka C, Filis N, Voulgaris S. Meningioma grading based on positron emission tomography: A systematic review and meta-analysis. World Neurosurg X 2023; 18:100167. [PMID: 36825220 PMCID: PMC9941365 DOI: 10.1016/j.wnsx.2023.100167] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2022] [Revised: 01/25/2023] [Accepted: 01/29/2023] [Indexed: 02/05/2023] Open
Abstract
Introduction Meningiomas are the most common central nervous system tumor in adults. Knowledge of the tumor grade can guide optimal treatment timing and shape personalized follow-up strategies. Positron emission tomography (PET) has been utilized for the metabolic assessment of various intracranial space-occupying lesions. Herewith, we set out to evaluate the diagnostic accuracy of PET for the noninvasive assessment of meningioma's grade. Materials and methods The Medline, Scopus and Cochrane databases were systematically searched in March 2022 for studies that evaluated the sensitivity and specificity of PET compared to the gold standard of histological diagnosis in the grading of meningiomas. Summary statistics will be calculated and scatter plots, summary curve from the HSROC model and posterior predictions by empirical Bayes estimates will be presented. Results Five studies consisting of 242 patients with a total of 196 low-grade (Grade 1) and 46 high grade (Grade 2/3) meningiomas were included in our analysis. Three of the included studies used 18F-FDG, one study used 18F-FLT and one used(Whiting et al., 2011) 18 F-FET as PET tracers. The pooled sensitivity was 76% (95% CI: 52%-91%) and the pooled specificity was 89% (95% CI: 83%-93%). The diagnostic odds ratio was 27.17 (95% CI: 9.22-80.06), the positive likelihood ratio was 7.18 (95% CI: 4.54-11.34) and the negative likelihood ratio was 0.26 (95% CI: 0.11-0.61). Conclusion PET is a promising and viable option as a noninvasive imaging tool to differentiate the meningioma grades. However, currently it cannot overtake the gold standard of histological grade confirmation. More studies are required for further validation and refinement of this imaging technique and assessment of other radiotracers as well.
Collapse
Key Words
- 1/LR-, inverse of the negative likelihood ratio
- 11C-MET, 11C-methionine
- 18F-FDG, fluorine-18 fluorodeoxyglucose
- 18F-FET, O-(2-[18F]Fluoroethyl)-l-tyrosine
- CIs, 95% confidence intervals
- CT, computerized tomography
- DOR, diagnostic odds ratio
- HSROC, hierarchical summary receiver operating characteristic
- LR+, positive likelihood ratios
- LR−, negative likelihood ratios
- MRI, magnetic resonance imaging
- Mendingioma
- Meta-analysis
- PET
- PET, positron emission tomography
- SPECT, single-photon emission computerized tomography
- SUV, standardized uptake value
- SUVmax, maximum standardized uptake value
- TBR, tumour-to-brain ratios
- TGR, tumor-to-contralateral gray matter ratios
- WHO, World Health Organization
- [18F]FLT, 3′-deoxy-3′-[18F]fluorothymidine
Collapse
Affiliation(s)
- Panagiotis Filis
- Department of Neurosurgery, University of Ioannina, School of Medicine, Greece,Department of Hygiene and Epidemiology, School of Medicine, University of Ioannina, Greece
| | - George A. Alexiou
- Department of Neurosurgery, University of Ioannina, School of Medicine, Greece,Corresponding author.
| | - Andreas Zigouris
- Department of Neurosurgery, University of Ioannina, School of Medicine, Greece
| | - Chrissa Sioka
- Department of Nuclear Medicine, University of Ioannina, Greece
| | - Nikolaos Filis
- Department of Neurosurgery, University of Ioannina, School of Medicine, Greece
| | - Spyridon Voulgaris
- Department of Neurosurgery, University of Ioannina, School of Medicine, Greece
| |
Collapse
|
3
|
Jafari SH, Rabiei N, Taghizadieh M, Mirazimi SMA, Kowsari H, Farzin MA, Razaghi Bahabadi Z, Rezaei S, Mohammadi AH, Alirezaei Z, Dashti F, Nejati M. Joint application of biochemical markers and imaging techniques in the accurate and early detection of glioblastoma. Pathol Res Pract 2021; 224:153528. [PMID: 34171601 DOI: 10.1016/j.prp.2021.153528] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/22/2021] [Revised: 06/09/2021] [Accepted: 06/14/2021] [Indexed: 11/28/2022]
Abstract
Glioblastoma is a primary brain tumor with the most metastatic effect in adults. Despite the wide range of multidimensional treatments, tumor heterogeneity is one of the main causes of tumor spread and gives great complexity to diagnostic and therapeutic methods. Therefore, featuring noble noninvasive prognostic methods that are focused on glioblastoma heterogeneity is perceived as an urgent need. Imaging neuro-oncological biomarkers including MGMT (O6-methylguanine-DNA methyltransferase) promoter methylation status, tumor grade along with other tumor characteristics and demographic features (e.g., age) are commonly referred to during diagnostic, therapeutic and prognostic processes. Therefore, the use of new noninvasive prognostic methods focused on glioblastoma heterogeneity is considered an urgent need. Some neuronal biomarkers, including the promoter methylation status of the promoter MGMT, the characteristics and grade of the tumor, along with the patient's demographics (such as age and sex) are involved in diagnosis, treatment, and prognosis. Among the wide array of imaging techniques, magnetic resonance imaging combined with the more physiologically detailed technique of H-magnetic resonance spectroscopy can be useful in diagnosing neurological cancer patients. In addition, intracranial tumor qualitative analysis and sometimes tumor biopsies help in accurate diagnosis. This review summarizes the evidence for biochemical biomarkers being a reliable biomarker in the early detection and disease management in GBM. Moreover, we highlight the correlation between Imaging techniques and biochemical biomarkers and ask whether they can be combined.
Collapse
Affiliation(s)
- Seyed Hamed Jafari
- Medical Imaging Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Nikta Rabiei
- School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Mohammad Taghizadieh
- Department of Pathology, School of Medicine, Center for Women's Health Research Zahra, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Sayad Mohammad Ali Mirazimi
- School of Medicine, Kashan University of Medical Sciences, Kashan, Iran; Student Research Committee, Kashan University of Medical Sciences, Kashan, Iran
| | - Hamed Kowsari
- School of Medicine, Kashan University of Medical Sciences, Kashan, Iran; Student Research Committee, Kashan University of Medical Sciences, Kashan, Iran
| | - Mohammad Amin Farzin
- Department of Laboratory Medicine, School of Allied Medical Sciences, Kashan University of Medical Sciences, Kashan, Iran
| | - Zahra Razaghi Bahabadi
- School of Medicine, Kashan University of Medical Sciences, Kashan, Iran; Student Research Committee, Kashan University of Medical Sciences, Kashan, Iran
| | - Samaneh Rezaei
- Department of Medical Biotechnology, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Amir Hossein Mohammadi
- Research Center for Biochemistry and Nutrition in Metabolic Diseases, Institute for Basic Sciences, Kashan University of Medical Sciences, Kashan, Iran
| | - Zahra Alirezaei
- Department of Medical Physics, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran; Paramedical School, Bushehr University of Medical Sciences, Bushehr, Iran.
| | - Fatemeh Dashti
- School of Medicine, Kashan University of Medical Sciences, Kashan, Iran; Student Research Committee, Kashan University of Medical Sciences, Kashan, Iran.
| | - Majid Nejati
- Anatomical Sciences Research Center, Institute for Basic Sciences, Kashan University of Medical Sciences, Kashan, Iran.
| |
Collapse
|
4
|
Daboudi M, Papadaki E, Vakis A, Chlouverakis G, Makrakis D, Karageorgou D, Simos P, Koukouraki S. Brain SPECT and perfusion MRI: do they provide complementary information about the tumour lesion and its grading? Clin Radiol 2019; 74:652.e1-652.e9. [PMID: 31164195 DOI: 10.1016/j.crad.2019.03.025] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2018] [Accepted: 03/22/2019] [Indexed: 10/26/2022]
Abstract
AIM To evaluate the relative and combined utility of 99mTc-tetrofosmin (99mTc-TF) brain single-photon-emission computed tomography (SPECT) and dynamic susceptibility contrast (DSC) perfusion magnetic resonance imaging (MRI) in grading brain gliomas. MATERIALS AND METHODS Thirty-six patients with clinically suspected brain tumours were assessed by 99mTc-TF SPECT and DSC-MRI. Brain tumour malignancy was confirmed in all patients at histopathology. On both techniques brain lesions were evaluated via visual and semi-quantitative analysis methods (deriving tetrofosmin index [T-index] and relative cerebral blood volume [rCBV] ratios, respectively). RESULTS 99mTc-TF SPECT showed abnormally elevated tracer uptake in 31/36 patients whereas MRI detected the brain tumour in all patients. Optimal cut-off values of each index for discriminating between low- and high-grade gliomas were obtained through receiver operating characteristic (ROC) analyses. A T-index cut-off of 6.35 ensured 82% sensitivity and 71% specificity for discriminating between high- and low-grade gliomas, whereas a relative rCBV ratio cut-off of 1.80 achieved 91% sensitivity and 100% specificity. Requiring a positive result on either technique to characterise a high-grade glioma was associated with similar specificity and slightly increased sensitivity. CONCLUSION Both imaging techniques, 99mTF SPECT and DSC MRI, may provide complementary indices of tumour grade and have an independent diagnostic value for high-risk tumours.
Collapse
Affiliation(s)
- M Daboudi
- Department of Nuclear Medicine, School of Medicine, University of Crete, Heraklion, Crete, Greece.
| | - E Papadaki
- Department of Radiology, School of Medicine, University of Crete, Heraklion, Crete, Greece; Institute of Computer Science, Foundation of Research and Technology, Heraklion, Crete, Greece
| | - A Vakis
- Department of Neurosurgery, School of Medicine, University of Crete, Heraklion, Crete, Greece
| | - G Chlouverakis
- Biostatistics Lab., Department of Social and Family Medicine, School of Medicine, University of Crete, Heraklion, Crete, Greece
| | - D Makrakis
- Department of Radiology, School of Medicine, University of Crete, Heraklion, Crete, Greece
| | - D Karageorgou
- Department of Radiology, School of Medicine, University of Crete, Heraklion, Crete, Greece
| | - P Simos
- Institute of Computer Science, Foundation of Research and Technology, Heraklion, Crete, Greece; Department of Psychiatry, School of Medicine, University of Crete, Heraklion, Crete, Greece
| | - S Koukouraki
- Department of Nuclear Medicine, School of Medicine, University of Crete, Heraklion, Crete, Greece
| |
Collapse
|
5
|
Siasios I, Valotassiou V, Kapsalaki E, Tsougos I, Georgoulias P, Fotiadou A, Ioannou M, Koukoulis G, Dimopoulos V, Fountas K. Magnetic Resonance Spectroscopy and Single-Photon Emission Computed Tomography in the Evaluation of Cerebral Tumors: A Case Report. J Clin Med Res 2016; 9:74-78. [PMID: 27924180 PMCID: PMC5127220 DOI: 10.14740/jocmr2775w] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/21/2016] [Indexed: 12/16/2022] Open
Abstract
In their daily clinical practice, physicians have to confront diagnostic dilemmas which cannot be resolved by the application of only one imaging technique. In this case report, we present a 66-year-old woman who was admitted to our institution for the surgical resection of a recently diagnosed brain tumor. The patient had a history of epileptic seizures and was hospitalized in the past for anti-phospholipid syndrome related to a non-Hodgkin lymphoma in remission. Magnetic resonance imaging (MRI) examination revealed an enhancing right parasagittal lesion with significant edema suggestive of a high grade glioma. Advanced MRI techniques including proton magnetic resonance spectroscopy (1H-MRS) showed findings compatible of glioma. An additional examination was performed as part of a protocol that we are routinely performing in our institution for all brain tumors including not only the gold standard advanced MRI techniques but also single-photon emission computed tomography (SPECT) with technetium-99m (Tc99m). Brain SPECT indicated the presence of a meningioma which was verified by the histopathology of the resected specimen. In conclusion, a multimodality approach for the pre-surgical assessment of brain tumors has significant advantages not only for the diagnosis but also for the evaluation of intracranial tumors histology.
Collapse
Affiliation(s)
- Ioannis Siasios
- Department of Neurosurgery, University Hospital of Larissa, Greece; Department of Neurosurgery, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, State University of New York, Buffalo, Buffalo, NY, USA
| | | | - Eftychia Kapsalaki
- Department of Diagnostic Radiology, University Hospital of Larissa, Greece
| | - Ioannis Tsougos
- Department of Medical Physics, University Hospital of Larissa, Greece
| | | | | | - Maria Ioannou
- Department of Pathology, University Hospital of Larissa, Greece
| | | | - Vassilios Dimopoulos
- Department of Neurosurgery, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, State University of New York, Buffalo, Buffalo, NY, USA
| | - Kostas Fountas
- Department of Neurosurgery, University Hospital of Larissa, Greece
| |
Collapse
|
6
|
Abstract
Brain tumors are one of the most challenging disorders encountered, and early and accurate diagnosis is essential for the management and treatment of these tumors. In this article, diagnostic modalities including single-photon emission computed tomography, positron emission tomography, magnetic resonance imaging, and optical imaging are reviewed. We mainly focus on the newly emerging, specific imaging probes, and their potential use in animal models and clinical settings.
Collapse
Affiliation(s)
- Huile Gao
- Key Laboratory of Smart Drug Delivery, Ministry of Education & PLA, School of Pharmacy, Fudan University, 826 Zhangheng Road, Shanghai 201203, China
| | - Xinguo Jiang
- Key Laboratory of Smart Drug Delivery, Ministry of Education & PLA, School of Pharmacy, Fudan University, 826 Zhangheng Road, Shanghai 201203, China
| |
Collapse
|
7
|
Valotassiou V, Leondi A, Angelidis G, Psimadas D, Georgoulias P. SPECT and PET imaging of meningiomas. ScientificWorldJournal 2012; 2012:412580. [PMID: 22623896 PMCID: PMC3353476 DOI: 10.1100/2012/412580] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2012] [Accepted: 01/26/2012] [Indexed: 12/21/2022] Open
Abstract
Meningiomas arise from the meningothelial cells of the arachnoid membranes. They are the most common primary intracranial neoplasms and represent about 20% of all intracranial tumors. They are usually diagnosed after the third decade of life and they are more frequent in women than in men. According to the World Health Organization (WHO) criteria, meningiomas can be classified into grade I meningiomas, which are benign, grade II (atypical) and grade III (anaplastic) meningiomas, which have a much more aggressive clinical behaviour. Computed Tomography (CT) and Magnetic Resonance Imaging (MRI) are routinely used in the diagnostic workup of patients with meningiomas. Molecular Nuclear Medicine Imaging with Single Photon Emission Computed Tomography (SPECT) and Positron Emission Tomography (PET) could provide complementary information to CT and MRI. Various SPECT and PET tracers may provide information about cellular processes and biological characteristics of meningiomas. Therefore, SPECT and PET imaging could be used for the preoperative noninvasive diagnosis and differential diagnosis of meningiomas, prediction of tumor grade and tumor recurrence, response to treatment, target volume delineation for radiation therapy planning, and distinction between residual or recurrent tumour from scar tissue.
Collapse
Affiliation(s)
- Varvara Valotassiou
- Nuclear Medicine Department, University Hospital of Larissa, Mezourlo, Larissa, Greece.
| | | | | | | | | |
Collapse
|
8
|
Alexiou GA, Tsiouris S, Voulgaris S, Kyritsis AP, Fotopoulos AD. Imaging Meningiomas With 99mTc-Tetrofosmin SPECT. Neurosurgery 2012; 70:E1055; author reply E1055-6. [DOI: 10.1227/neu.0b013e31824868d9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
|
9
|
Frederick Cornelius J, Hänggi D, Sabel M, Jakob Steiger H, Josef Langen K, Stoffels G. In Reply. Neurosurgery 2012. [DOI: 10.1227/neu.0b013e31824869e6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
|
10
|
Abstract
Although meningiomas are the most common tumor in the central nervous system, their incidence, epidemiology, and clinical outcomes have historically been poorly defined. This has been attributed to their benign course, difficulty obtaining histologic diagnosis, and lack of uniform database registration. Their clinical behavior can range from a silent incidentaloma to a lethal tumor. Projections of an aging population should raise medical awareness of an expectant rise in the incidence of meningiomas. This disease increases with advancing age, has a female predilection, and exposure to ionizing radiation is associated with a higher risk for disease development. There have been minimal advances in treatment, except in radiation therapy. Although no U.S. Food and Drug Administration-approved systemic therapy exists, there are treatment options that include hydroxyurea and sandostatin. Currently, no molecularly targeted therapy has provided clinical benefit, although recurring molecular alterations are present and novel therapies are being investigated.
Collapse
Affiliation(s)
| | - Bridget J. McCarthy
- Epidemiology/Biostatistics, University of Illinois at Chicago, Chicago, Illinois, USA
| | | |
Collapse
|
11
|
Alexiou GA, Tsiouris S, Kyritsis AP, Fotakopoulos G, Goussia A, Voulgaris S, Fotopoulos AD. The Value of 99mTc-Tetrofosmin Brain SPECT in Predicting Survival in Patients with Glioblastoma Multiforme. J Nucl Med 2010; 51:1923-6. [DOI: 10.2967/jnumed.110.080929] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
|
12
|
Alexiou GA, Goussia A, Kyritsis AP, Tsiouris S, Ntoulia A, Malamou-Mitsi V, Voulgaris S, Fotopoulos AD. Influence of Glioma's Multidrug Resistance Phenotype on 99mTc-Tetrofosmin Uptake. Mol Imaging Biol 2010; 13:348-51. [DOI: 10.1007/s11307-010-0369-y] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
|
13
|
Characterization of intracranial space-occupying lesions by 99mTc-Tetrofosmin SPECT. J Neurooncol 2010; 101:83-9. [DOI: 10.1007/s11060-010-0230-9] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2009] [Accepted: 05/11/2010] [Indexed: 11/26/2022]
|
14
|
Alexiou GA, Gogou P, Markoula S, Kyritsis AP. Management of meningiomas. Clin Neurol Neurosurg 2010; 112:177-82. [DOI: 10.1016/j.clineuro.2009.12.011] [Citation(s) in RCA: 80] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2009] [Revised: 10/14/2009] [Accepted: 12/11/2009] [Indexed: 10/20/2022]
|
15
|
Alexiou GA, Tsiouris S, Vartholomatos G, Fotakopoulos G, Papadopoulos A, Kyritsis AP, Voulgaris S, Fotopoulos AD. Correlation of glioma proliferation assessed by flow cytometry with 99mTc-Tetrofosmin SPECT uptake. Clin Neurol Neurosurg 2009; 111:808-11. [DOI: 10.1016/j.clineuro.2009.08.009] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2009] [Revised: 06/13/2009] [Accepted: 08/09/2009] [Indexed: 11/26/2022]
|
16
|
Glioma recurrence versus radiation necrosis: accuracy of current imaging modalities. J Neurooncol 2009; 95:1-11. [DOI: 10.1007/s11060-009-9897-1] [Citation(s) in RCA: 65] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2008] [Accepted: 04/06/2009] [Indexed: 01/09/2023]
|
17
|
Alexiou GA, Voulgaris S, Polyzoidis K, Fotopoulos AD, Tsiouris S, Kyritsis AP. Comment on "Differentiation of tumour recurrence from radiation necrosis in high-grade gliomas using (201)Tl-SPECT". J Clin Neurosci 2009; 16:1112. [PMID: 19477130 DOI: 10.1016/j.jocn.2008.11.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2008] [Accepted: 11/10/2008] [Indexed: 11/19/2022]
|
18
|
99mTc-Tetrofosmin SPECT for Glioma Evaluation. Mol Imaging Biol 2009; 11:223. [DOI: 10.1007/s11307-009-0202-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2008] [Accepted: 10/24/2008] [Indexed: 10/21/2022]
|
19
|
Alexiou GA, Voulgaris S, Tsiouris S, Fotopoulos AD, Kyritsis AP, Polyzoidis KS. Technetium Tc99m-tetrofosmin brain single-photon emission CT for the diagnosis of malignant meningiomas. AJNR Am J Neuroradiol 2009; 30:E21. [PMID: 19193747 DOI: 10.3174/ajnr.a1286] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
|
20
|
Alexiou GA, Tsiouris S, Kyritsis AP, Polyzoidis KS, Fotopoulos AD. Brain SPECT by 99mTc-Tetrofosmin for the Differentiation of Tumor Recurrence from Radiation Injury. J Nucl Med 2008; 49:1733-4; author reply 1734. [DOI: 10.2967/jnumed.108.054494] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
|