Clinical evaluation of thallium-201 single photon emission computed tomography in equivocal neuroradiological supratentorial lesions.
BACKGROUND
We performed cerebral 201Tl SPECT study on 38 presurgical patients with equivocal neuroradiological supratentorial lesions to detect differences in 201Tl uptake index between tumor/non-tumor and high-grade/low-grade samples.


METHODS
Authors identified 38 cases with presurgical equivocal neuroradiological supratentorial mass lesions. All cases were submitted to histological confirmation of the lesion by biopsy, sub-total or gross-total removal of the tumor. Between 23 patients suffering from gliomas, 13 were histologically classified as being of low-grade malignant tumors and 10 were classified as being of high-grade malignancy. Fifteen non-tumor histopathological specimens were also detected. The 201Tl index was defined as the ratio of average counts per pixel in the lesion to these in the opposite region. Analysis of variance (ANOVA) and unpaired Student's OtO-test statistical methods were applied. Actuarial survival time from the date of diagnosis was calculated using the Kaplan-Meier method. Follow-up evaluation and survival time were obtained through referring physicians. Cerebral CT or MR images were obtained every three months after discharged, or more often if indicated.


RESULTS
Results showed that the 201Tl uptake index ranged from 1.10 to 3.00 in the tumors lesions (mean+/-SD: 1.68+/-0.51) and from 0.80 to 1.40 in the non-tumors lesions (mean+/-SD: 1.07+/-0.17), (alpha < 0.0006 percent;). The 201Tl uptake index ranged from 1.10 to 2.30 in 13 patients with low-grade tumors (mean+/-SD: 1.45+/-0.34) and from 1.30 to 3.00 in 10 patients with high-grade tumors (mean+/-SD: 1.98+/-0.55), (alpha < 0.5 percent;).


CONCLUSIONS
Our results demonstrate the clinical utility of 201Tl brain SPECT to differentiate equivocal neuroradiological supratentorial lesions and to correlate relationship between preoperative diagnosis, histological tumor grade and prognosis.
Cipri
S
S
Division of Neurosurgery, Bianchi-Melacrino-Morelli, Hospitals, Reggio Calabria, Italy.
Mannino
R
R
Ruggieri
R
R
Gambardella
G
G
D000328:Adult; D000368:Aged; D001932:Brain Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology / Q000503:physiopathology; D003392:Cranial Sinuses / Q000000981:diagnostic imaging / Q000473:pathology; D003937:Diagnosis, Differential; D018450:Disease Progression; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D013794:Thallium Radioisotopes; D015899:Tomography, Emission-Computed, Single-Photon; D014057:Tomography, X-Ray Computed; D020246:Venous Thrombosis / Q000000981:diagnostic imaging / Q000473:pathology
D013794:Thallium Radioisotopes