Differentiation of tumor recurrence from radiation necrosis in high-grade gliomas using ²⁰¹Tl-SPECT

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• 作者：Jeanne Tie ; Dishan H. Gunawardana ; Mark A. Rosenthal
• 关键词：²⁰¹Tl-SPECT ; Radiation necrosis ; High-grade gliomas
• 刊名：Journal of Clinical Neuroscience
• 出版年：2008
• 出版时间：December 2008
• 年：2008
• 卷：15
• 期：12
• 页码：1327-1334
• 全文大小：238 K

文摘

MRI is routinely performed to detect recurrence in patients with primary brain tumors, but it may not differentiate recurrent tumor from radiation-induced necrosis reliably. Thallium-201 single-photon emission computed tomography (²⁰¹Tl-SPECT) might be useful in distinguishing between these two clinical entities. In a retrospective study ²⁰¹Tl-SPECT studies with corresponding MRI studies in 19 patients with clinical or radiological suspicion of high-grade tumor recurrence were reviewed. The diagnostic accuracies of both modalities were based on the subsequent histology or clinical course where biopsy was not performed. Post-scan histology was available in nine patients (43 % ) who underwent re-resection. The SPECT result determined management in six patients (29 % ). Post-SPECT survival was significantly better in patients with negative ²⁰¹Tl-SPECT studies compared to patients with positive studies (median survival 15 + vs. 6 months) (p = 0.04, log-rank test). The sensitivity and specificity of ²⁰¹Tl-SPECT in diagnosing tumor recurrence were 83 % and 100 % , respectively. ²⁰¹Tl-SPECT can accurately differentiate tumor recurrence from radiation necrosis in patients with high-grade gliomas and abnormal MRI findings post irradiation. This is reflected in a significantly longer post-scan survival time in patients with a negative ²⁰¹Tl-SPECT result.