• Marco Krengli, Gianfranco Loi, Gianmauro Sacchetti, Irene Manfredda, Giuseppina Gambaro, Marco Brambilla, Alessandro Carriero, and Eugenio Inglese.
• Radiotherapy, University of Piemonte Orientale, Novara, Italy. krengli@med.unipmn.it
• Strahlenther Onkol. 2007 Dec 1; 183 (12): 689-94.

Background And PurposeComputed tomography (CT) and magnetic resonance imaging (MRI) are traditionally used for treatment planning of high-grade glioma. 99m Tc-methoxy-isobutyl-isonitrile (MIBI) single-photon emission computed tomography (SPECT) showed high sensitivity and specificity in literature series. In the present study, it was investigated how the information provided by 99m Tc-MIBI SPECT and MRI fusion could affect target delineation for radiotherapy of high-grade glioma.Patients And Methods21 patients with high-grade glioma were studied by MRI and 99m Tc-MIBI SPECT imaging. The gross tumor volume (GTV) was outlined on MRI (MRI-GTV) and SPECT images (SPECT-GTV). Three additional volumes were analyzed: the (MRI+SPECT)-GTV representing the whole amount of MRI-GTV plus SPECT-GTV, the (MRI&SPECT)-GTV identified by the overlapping region of MRI-GTV and SPECT-GTV, and the (SPECT/MRI)-GTV identified by the extension of SPECT-GTV outside MRI-GTV.ResultsMRI contrast-enhanced and 99m Tc-MIBI SPECT-positive lesions were found in all 21 patients. The average SPECT-GTV was slightly larger than the average MRI-GTV, with greater difference for resected than for unresected cases. The average increment of (MRI+SPECT)-GTV compared to MRI-GTV was 33%, being significantly higher for resected than for unresected cases (p = 0.006).ConclusionThe fusion of 99m Tc-MIBI SPECT and MRI significantly affected the delineation of the target volume identified by MRI alone.

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