Abstract
Stereotactic radiosurgery is an elegant alternative to microsurgery in both skull base meningiomas and solitary brain metastasis. Though efficacy for both entities has been established prognostic variables pertaining to individual tumour biology have not yet been identified. Therefore the authors measured regional glucose utilisation, thallium-uptake and blood flow in 20 patients (10 meningiomas, 10 metastasis) before and after LINAC radiosurgery. Measurements were performed using SPECT and stable xenon-CT. The mean tumour dose given was 16.3 and 19.5 Gy in meningiomas and metastasis respectively. Metastatic tumours were hypermetabolic in comparison to contralateral normal brain and responders to radiosurgery showed a lower tumour/brain ratio than non-responders (1.43 vs 0.91 respectively, p< 0.01). Meningiomas did not exhibit hypermetabolism and therapeutic outcome was not related to glucose utilisation. Thallium-uptake, however, was closely related to therapeutic response in meningiomas (1.37 vs 2.2 in responders vs non-responders, p < 0.01). This relationship could not be established in metastatic lesions. Blood flow was widely distributed in both meningiomas and metastasis (26–72.8 and 30.2–70.8 ml/100 g/min). rCBF did not correlate with therapeutic outcome.
Using FDG-SPECT and thallium-201-SPECT the authors were able to distinguish between tumours likely to respond to stereotactic radiosurgery and those not prone to respond. Furthermore the methodology can be used to monitor therapeutic response in treated tumours before morphologic changes occur.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
References
Alavi JB, Alavi A, Chawluk J, Kushner M, Powe J, Hickey W, Reivich M (1988) Positron emission tomography in patients with glioma. Cancer 62: 1074–1078
Alexander E, Moriarty TM, Davis RB, Wen PY, Fine HA, Black PM, Kooy HM, Loeffler JS (1995) Stereotactic radiosurgery for the definitive non-invasive treatment of brain metastases. J Natl Cancer Inst 87: 34–40
Brismar T, Collins VP, Kesselberg M (1989) Thallium-201-uptake relates to membrane potential and potassium permeability in human glioma cells. Brain Res 500: 30–36
Engenhart R, Kimmig BN, Höver KH, Wowra B, Sturm V, van Kaick G, Wannenmacher M (1990) Stereotactic single high dose radiation therapy of benign intracranial meningeomas. Int J Radiation Oncol Biol Phys 19: 1021–1026
Engenhart R, Kirnmig BN, Höver KH, Wowra B, Romahn J, Lorenz WJ, van Kaick G, Wannenmacher M (1993) Longterm follow-up for brain metastases treated by percutaneous stereotactic single high-dose irradiation. Cancer 71: 1353–1361
Flickinger JC, Kondziolka D, Lunsford D, Coffey RJ, Goodman ML, Shaw EG, Hudgins WR, Weiner R, Harsh GR, Sneed PK, Larsson DA (1994) A multi-institutional experience with stereotactic radiosurgery for solitary brain metastasis. Int J Radiation Oncol Biol Phys 28: 797–802
Ishibashi M, Taguchi A, Sugita Y, Morita S, Kawamura S, Umezaki N, Shigemori M, Hayabuchi N (1995) Thallium-201 in brain tumors: relationship between tumor cell activity in astrocytic tumor and proliferating cell nuclear antigen. J Nucl Med 36: 2201–2206
Kondiziolka D, Lunsford D, Coffey RJ, Flickinger JC (1991) Stereotactic radiosurgery of meningeomas. J Neurosurg 74: 552–559
Patronas NJ, di Chiro G, Kufta C, Bairamian D, Kornblith PL, Simon R, Larson SM (1985) Prediction of survival in glioma patients by means of positron emission tomography. J Neurosurg 62: 816–822
Valentino V, Schinaia G, Raimondi AJ (1993) The results of radiosurgical management of 72 middle fossa meningeomas. Acta Neurochir (Wien) 122: 60–70
Author information
Authors and Affiliations
Editor information
Rights and permissions
Copyright information
© 1997 Springer-Verlag Wien
About this paper
Cite this paper
Warnke, P.C., Berlis, A., Weyerbrock, A., Ostertag, C.B. (1997). Effect of LINAC Radiosurgery on Regional Cerebral Blood Flow, Glucose Metabolism and Sodium-Potassium AtPase in Skull Base Meningiomas and Metastasis. In: Ostertag, C.B., Thomas, D.G.T., Bosch, A., Linderoth, B., Broggi, G. (eds) Advances in Stereotactic and Functional Neurosurgery 12. Acta Neurochirurgica Supplements, vol 68. Springer, Vienna. https://doi.org/10.1007/978-3-7091-6513-3_23
Download citation
DOI: https://doi.org/10.1007/978-3-7091-6513-3_23
Publisher Name: Springer, Vienna
Print ISBN: 978-3-7091-7341-1
Online ISBN: 978-3-7091-6513-3
eBook Packages: Springer Book Archive