[Differential diagnosis between recurrence of gliomas and radiation necrosis by 201TlCl SPECT].
We studied the value of quantitative 201Thallium Chloride brain SPECT (Tl SPECT) in the differentiation between glioma recurrence and radiation necrosis. A total of 44 patients--26 patients with recurrent malignant glioma, 10 patients with low grade glioma and 8 patients with radiation necrosis--underwent Tl SPECT. The patients had early SPECT images taken 15 minutes after intravenous injection of 3mCi of 201TlCl and also had delayed SPECT images taken 4 hours after injection. Count ratios of a lesion to normal brain (L/N) were calculated from the rectangular ROI for the quantitative analysis. Count ratios of the lesion seen on the delayed image to that on the early image (D/E) were also calculated. In 26 patients with recurrent malignant gliomas, L/N ratio ranged from 2.6 to 12.6 with a mean of 4.4 +/- 2.3 on early images. All patients had L/N ratios greater than 2.5. However, in 8 patients with cerebral radiation necrosis, L/N ratios ranged from 1.5 to 2.4 with a mean of 2.0 +/- 0.3 on early image. L/N ratios were always 2.5 or less. In 8 patients with cerebral radiation necrosis, there were little differences between the L/N ratios for early and delayed images. D/E ratios ranged from 1.0 to 1.3 with a mean of 1.2 +/- 0.1. These results confirmed the validity of Tl SPECT in differentiating cerebral radiation necrosis from recurrent malignant gliomas. In 10 patients with low grade astrocytoma there was a subtle uptake or no uptake of Tl and the ratios of these patients were rated at 1.0.(ABSTRACT TRUNCATED AT 250 WORDS)
Nakamura
O
O
Department of Neurosurgery, Tokyo Metropolitan Komagome Hospital, Japan.
Kosuda
S
S
Okamoto
K
K
Kaneko
M
M
Nakamura
H
H
Shitara
N
N
Suzuki
K
K
D000328:Adult; D000368:Aged; D001921:Brain / Q000000981:diagnostic imaging / Q000473:pathology*; D001932:Brain Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology / Q000532:radiotherapy; D016371:Cranial Irradiation / Q000009:adverse effects; D003937:Diagnosis, Differential; D005260:Female; D005910:Glioma / Q000000981:diagnostic imaging* / Q000473:pathology / Q000532:radiotherapy; D006801:Humans; D008297:Male; D008875:Middle Aged; D009336:Necrosis; D009364:Neoplasm Recurrence, Local / Q000000981:diagnostic imaging*; D011832:Radiation Injuries / Q000000981:diagnostic imaging*; D013793:Thallium; D013794:Thallium Radioisotopes; D015899:Tomography, Emission-Computed, Single-Photon
D013794:Thallium Radioisotopes; C027549:thallium chloride; D013793:Thallium