Katano Hiroyuki, Karasawa Kunio, Sugiyama Naotake, Yamashita Nobuko, Ohkura Atsuhiko, Watanabe Kenichi, Kamiya Ken
Department of Neurosurgery, Nagoya City Higashi General Hospital, 1-2-23 Wakamizu, Chikusa-ku, Nagoya 464-8547, Japan.
J Clin Neurosci. 2002 Nov;9(6):653-8. doi: 10.1054/jocn.2002.1142.
Thallium-201 chloride single photon emission computed tomography ((201)TlCl SPECT) has been applied extensively for studies of human tumors. To assess which indices for (201)TlCl SPECT are most useful for diagnosing brain lesions, a total of 82 patients (98 images) with intracranial abnormalities were investigated. Seventy-six cases with abnormal (201)Tl uptake were evaluated in terms of six different (201)Tl uptake and retention indices: (1) average early (201)Tl uptake = Av.Le/Av.Be; (2) maximum early (201)Tl uptake = Mx.Le/Av.Be; (3)(201) Tl retention A = Av.Ld/Av.Le; (4) (201)Tl retention B = Mx.Ld/Mx.Le; (5) (201)Tl retention C = (Av.Ld/Av.Bd)/(Av.Le/Av.Be); (6) (201)Tl retention D = (Mx.Ld/Av.Bd)/(Mx.Le/Av.Be), where Av.Le and Mx.Le are average and maximum early counts for lesions, Av.Be and Av.Bd are average early and delayed counts for contralateral normal brains, and Av.Ld and Mx.Ld are average and maximum delayed counts for lesions. Comparison of patients with benign and malignant lesions did not demonstrate significant differences with any of the indices. However, low (I-II) and high (III-IV) grade astrocytomas varied in their average and maximum early (201)Tl uptake indices (both P = 0.0026). For patients with and without meningiomas, P values for indices of maximum early(201) Tl uptake and (201)Tl retention A and B were 0.0338, 0.0005, 0.0002, respectively. While comparison of patients with metastatic brain tumors and gliomas again showed no significant differences between the groups, the presence or absence of calcification was associated with significant variation in all the indices. With (201)TlCl-SPECT imaging, the average and maximum early (201)Tl uptake indices are appropriate for the assessment of tumor viability or malignancy, while (201)Tl retention indices (A,B) are useful for tumor differentiation, especially with meningiomas. Choice of suitable indices should enhance the utility of (201)TlCl-SPECT imaging in pre- and postoperative evaluation of intracranial lesions.
氯化铊-201单光子发射计算机断层扫描（（201）TlCl SPECT）已广泛应用于人类肿瘤研究。为了评估（201）TlCl SPECT的哪些指标对诊断脑病变最有用，共对82例（98幅图像）有颅内异常的患者进行了研究。对76例（201）Tl摄取异常的病例，根据6种不同的（201）Tl摄取和滞留指标进行了评估：（1）平均早期（201）Tl摄取=Av.Le/Av.Be；（2）最大早期（201）Tl摄取=Mx.Le/Av.Be；（3）（201）Tl滞留A=Av.Ld/Av.Le；（4）（201）Tl滞留B=Mx.Ld/Mx.Le；（5）（201）Tl滞留C=（Av.Ld/Av.Bd）/（Av.Le/Av.Be）；（6）（201）Tl滞留D=（Mx.Ld/Av.Bd）/（Mx.Le/Av.Be），其中Av.Le和Mx.Le是病变的平均和最大早期计数，Av.Be和Av.Bd是对侧正常脑的平均早期和延迟计数，Av.Ld和Mx.Ld是病变的平均和最大延迟计数。良性和恶性病变患者的比较在任何指标上均未显示出显著差异。然而，低（I-II）级和高（III-IV）级星形细胞瘤在其平均和最大早期（201）Tl摄取指标上有所不同（两者P=0.0026）。对于有和没有脑膜瘤的患者，最大早期（201）Tl摄取指标以及（201）Tl滞留A和B的P值分别为0.0338、0.0005、0.0002。虽然转移性脑肿瘤和胶质瘤患者的比较再次显示两组之间无显著差异，但钙化的有无与所有指标的显著差异相关。通过（201）TlCl-SPECT成像，平均和最大早期（201）Tl摄取指标适用于评估肿瘤的活性或恶性程度，而（201）Tl滞留指标（A、B）对肿瘤鉴别有用，尤其是对于脑膜瘤。选择合适的指标应能提高（201）TlCl-SPECT成像在颅内病变术前和术后评估中的效用。
