Multicentric Meningioma Evaluation With Tc-99m MIBI SPECT, CT, and MRI

Abstract

Meningiomas comprise 15% of adult intracranial tumors. They are often found in middle-aged adults and are more likely to occur in women. They are frequently located in the lateral hemisphere convexity, the parasagittal region, and the falx cerebri. They originate from meningoendothelial cells within the arachnoid villi, but may arise from other meningeal constituents, such as fibroblasts and blood vessels. Multicentric meningiomas present at an earlier age, often associated with neurofibromatosis type 2. The authors report a case of a woman with multicentric meningiomas which were identified with Tc-99m MIBI SPECT, MRI, and CT. Tc-99m MIBI uptake is related to 1) tissue perfusion, and 2) normal cell membrane and mitochondrial activity. In malignant tumors the uptake of Tc-99m MIBI also has been associated with the presence of P-glycoprotein in the cell membrane which is related to the multidrug resistant gene. The uptake of Tc-99m MIBI is not limited to malignant brain tumors, but also can be seen in benign and hypervascular meningiomas, as illustrated in this patient