Tc-99m MIBI SPECT in the differential diagnosis of non-neoplastic brain lesions associated with epilepsy

Abstract

Although considered experimental or investigational, techne tium scintigraphy has been reported to be useful in the diagnosis of structural brain lesions. Many series have evaluated its efficacy in the differentiation of brain malignancies from radiation necrosis, vascularmal formations, stroke, trauma or cerebral abscess. Accordingly, we decided to assess the usefulness of Tc-99m MIBI SPECT for the final diagnosis of suspected non-neoplas tic brain lesions associated with epilepsy. Ten patients (6 males and 4 fe males; mean age, 46.4±9.8 years) with symptomatic epilepsy asso ciated with finally non-neoplastic diagnosis were included in the study. SPECT was per formed 20 and 120 min after administration of 740 MBq (20 mCi) Tc-99m MIBI. Transverse, sagittal, and coronal views were reconstructed, and MIBI up take index was calculated on SPECT imaging. All patients under went structural neuroimaging (CT and/or MRI) that supposed cystic lesion in five patients, vascular abnormality in four and hemorrhage in one. In all cases SPECT showed no radiotracer accumulation. A correlation between lack of MIBI up take and non-tumor origin of the lesions was noted. In conclusion, we suggest that Tc-99m MIBI SPECT may be a useful noninvasive tool for the precise diagnosis of non-neoplastic brain lesions.Scripta Scientifica Medica 2009; 41(2): 179-181