ORIGINAL ARTICLES   

Journal of Neurosurgical Sciences 2001 June;45(2):75-82

Copyright © 2001 EDIZIONI MINERVA MEDICA

lingua: Inglese

Clinical evaluation of Thallium-201 single photon emission computed tomography in equivocal neuroradiological supratentorial lesions

Cipri S. ¹, Mannino R. ², ARuggieri R. ³, Gambardella G. ¹

¹ Division of Neurosurgery, “Bianchi-Melacrino-Morelli” Hospitals, Reggio Calabria, Italy; ² Service of Nuclear Medicine, “Bianchi-Melacrino-Morelli” Hospitals, Reggio Calabria, Italy; ³ Service of Medical Physics, “Bianchi-Melacrino-Morelli” Hospitals, Reggio Calabria, Italy

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 “t”-­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), (α<0.0006%). 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), (α<0.5%).
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.