Volumetric index of Tl-201 uptake in symptomatic patients after high - dose radiation treatment for high-grade gliomas

Journal Article · Mon May 01 04:00:00 EDT 1995 · Journal of Nuclear Medicine

OSTI ID:441601

Carvalho, P A; Garada, B M; Loeffler, J S ^[1]

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1. Brigham and Womens Hospital, Boston, MA (United States)

To verify the utility of a volumetric estimation of Tl-201 uptake in the context of possible astrocytoma recurrence after surgery, radiotherapy plus stereotactic boost (radiosurgery/brachitherapy), we analyzed sequential Tl-201/Tc99m-HMPAO brain SPECT studies of 28 patients (18 m/10 f). These were categorized as having tumor mass recurrence (TM), infiltrating tumor cells but no definite tumor mass (IT), or radiation changes and necrosis (RCN) after stereotactic biopsy and/or craniotomy. SPECT studies were obtained with a high-resolution dedicated gamma camera (CERASPECT, Digital Scinitgraphics, Inc.) and image acquisition was performed after intravenous Tl-201 (18.5 MBq) and Tc-99m HMPAO (740 MBq). In order to include relevant information about tumor burden, a volumetric index of Tl-201 uptake was expressed in cm{sup 3} related to voxel size (4.6 x 10{sup -3} cc) within an elliptical ROI that included the tumor area. Only voxels with a threshold {ge} 2 in relation to the average scalp Tl-201 uptake were included and this total number of voxels expressed in cc was compared to previously established maximal tumor/scalp Tl-201 uptake ratios (T/S) and histopathology. Results are presented as the median (min-max) and differences were considered significant for p<0.05. Differences were significant between all groups for both ratios and volume indices and correlation between the two variables was 0.90. In conclusion, the volumetric index of Tl-201 is similar to the maximal Tl-201 T/S ratios in discriminating tumor recurrence and radiation necrosis, suggesting a future role for the volumetric index estimation in the evaluation of treatment efficacy and patient follow-up.

• OSTI ID: 441601
• Report Number(s): CONF-950603--
• Journal Information: Journal of Nuclear Medicine, Journal Name: Journal of Nuclear Medicine Journal Issue: Suppl.5 Vol. 36; ISSN JNMEAQ; ISSN 0161-5505
• Country of Publication: United States
• Language: English

Related Subjects

55 BIOLOGY AND MEDICINE
BASIC STUDIES
BRAIN
DIAGNOSTIC TECHNIQUES
GLIOMAS
IMAGES
NECROSIS
NEOPLASMS
PATIENTS
RADIOTHERAPY
SINGLE PHOTON EMISSION COMPUTED TOMOGRAPHY
TECHNETIUM 99
THALLIUM 201
TUMOR CELLS
UPTAKE