Differential diagnosis between recurrence of gliomas and radiation necrosis by 201TlCl SPECT

O. Nakamura, S. Kosuda, K. Okamoto, M. Kaneko, H. Nakamura, N. Shitara, K. Suzuki

Research output: Contribution to journalArticle

8 Citations (Scopus)

Abstract

We studied the value of quantitative 201Thallium Chloride brain SPECT (T1 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 T1 SPECT. The patients had early SPECT images taken 15 minutes after intravenous injection of 3 mCi 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 T1 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 T1 and the ratios of these patients were rated at 1.0 T1 SPECT was also useful in discriminating low grade astrocytoma from malignant glioma or radiation necrosis.

Original languageEnglish
Pages (from-to)1051-1057
Number of pages7
JournalBrain and Nerve
Volume46
Issue number11
Publication statusPublished - 1994

Keywords

  • Thallium SPECT
  • gliomas
  • radiation necrosis

ASJC Scopus subject areas

  • Neuroscience(all)

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    Nakamura, O., Kosuda, S., Okamoto, K., Kaneko, M., Nakamura, H., Shitara, N., & Suzuki, K. (1994). Differential diagnosis between recurrence of gliomas and radiation necrosis by 201TlCl SPECT. Brain and Nerve, 46(11), 1051-1057.