Comparison of thallium 201 (TL) SPECT and F-18 fluoro-deoxyglucose (FDG) PET in the evaluation of MRI lesions in patients with gliomas after therapy
- Univ. of Texas M.D. Anderson Cancer Cancer, Houston, TX (United States); and others
Although both Tl-201 SPECT and F-18 FDG PET are helpful for the detection of recurrent gliomas, there is DO comparative study of these techniques for the same patient group. This study is performed to compare the efficacy of TL SPECT and FDG PET in differentiating recurrent glioma from post-treatment necrosis. Twenty patients (16M/4 F) treated for gliomas (surgery, radiation and/or chemotherapy) with 24 instructive MRI enhancing lesions underwent TL-201 SPECT and F-18 FDG PET within 1 week. The lesions were graded 0 to 4 (by consensus of three nuclear radiologists) with increasing confidence for recurrent tumors. Semiquantitative evaluations include lesion/scalp TL-201 ratios (L/S TL) and lesion/cortex F-18 FDG (L/C FDG) standard uptake value ratios. With clinical follow-up (12/24) and histopathologic confirmation (12/24), sensitivity and specificity for each grade were used to construct the receiver-operator-characteristic (ROC) curve for comparison. Recurrent gliomas were confirmed in 12/24 lesions (9/12 by pathology; 3/12 by follow-up). Post-treatment necrosis was confirmed in 12/24 lesions (9/12 by follow-up; 3/12 by pathology). The L/S TL ratios were [1.99{plus_minus}0.77] for gliomas and [1.14{plus_minus}0.22] for necrosis; the L/C FDG ratios were 0.86{plus_minus}0.43 for gliomas and 0.43{plus_minus}0.15 for necrosis. Although none of the semiquantitative measurements from TL SPECT and FDG PET could completely distinguish gliomas from post-treatment necrosis, FDG PET was superior to TL SPECT on the ROC curves. While TL-201 SPECT and F-18 FDG PET provide different and probably complementary metabolic measurements of brain lesions, this preliminary work suggests FDG PET is a better tool to evaluate enhancing MRI lesions in patients with treated gliomas. Further confirmation will require studies of more patients.
- OSTI ID:
- 198077
- Report Number(s):
- CONF-940605-; ISSN 0161-5505; TRN: 95:007029-0229
- Journal Information:
- Journal of Nuclear Medicine, Vol. 35, Issue Suppl.5; Conference: 41. annual meeting of the Society of Nuclear Medicine, Orlando, FL (United States), 5-8 Jun 1994; Other Information: PBD: May 1994
- Country of Publication:
- United States
- Language:
- English
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