Sugo Nobuo, Yokota Kyousuke, Kondo Kousuke, Harada Naoyuki, Aoki Yoshinori, Miyazaki Chikao, Nemoto Masaaki, Kano Toshiyuki, Ohishi Hitoshi, Seiki Yoshikatsu
Department of Neurosurgery, Toho University, Omori Medical Center, Tokyo, Japan.
Nucl Med Commun. 2006 Feb;27(2):143-9. doi: 10.1097/01.mnm.0000191853.34574.3f.
To estimate the usefulness of early dynamic 201Tl single photon emission computed tomography (SPECT) studies in distinguishing the histological malignancy of brain tumours.
Dynamic 201Tl SPECT was performed for 3 min per scan for 15 min immediately after the administration of 201TlCl in 110 patients with brain tumours (111 lesions). The data obtained each 3 min were used for dynamic SPECT, and the five sets of data obtained were added to acquire static SPECT data. For static SPECT, the static thallium index (STI) was calculated as the ratio of 201Tl uptake in the tumour to that of the contralateral normal brain. The ratio of the 201Tl uptake for each 3 min was defined as the dynamic thallium index (DTI). The dynamic thallium rate (DTR), as a per cent, was calculated as DTR=(DTI for every 3 min)/STI H 100. The five values were approximated as a linear function and the slope (%/min) was calculated.
In static SPECT, there was no significant difference between the STI of malignant tumours (glioblastoma and anaplastic astrocytoma) and that of benign tumours (low-grade glioma, meningioma, pituitary adenoma, neurinoma and haemangioblastoma) (3.7+/-1.5, 5.0+/-3.5, respectively). On dynamic SPECT, DTI increased markedly over 15 min for malignant tumours. In contrast, the DTI of benign tumours increased slightly, steadily or decreased. The slope of the linear functions calculated from the DTRs was much higher in the malignant tumour group than in the benign tumour group (P<0.001).
We suggest that the performance of 201Tl dynamic SPECT for 15 min is useful for distinguishing malignant brain tumours from benign brain tumours and reduces the examination stress of patients.
评估早期动态201铊单光子发射计算机断层扫描（SPECT）研究在鉴别脑肿瘤组织学恶性程度方面的作用。
对110例脑肿瘤患者（111个病灶）静脉注射氯化铊（201TlCl）后立即进行动态201Tl SPECT检查，每次扫描持续3分钟，共15分钟。每3分钟获取的数据用于动态SPECT，将获取的五组数据相加得到静态SPECT数据。对于静态SPECT，静态铊指数（STI）计算为肿瘤中201Tl摄取量与对侧正常脑组织摄取量的比值。每3分钟的201Tl摄取率定义为动态铊指数（DTI）。动态铊率（DTR）以百分比计算，公式为DTR =（每3分钟的DTI）/ STI×100。将五个值近似为线性函数并计算斜率（%/分钟）。
在静态SPECT中，恶性肿瘤（胶质母细胞瘤和间变性星形细胞瘤）与良性肿瘤（低级别胶质瘤、脑膜瘤、垂体腺瘤、神经鞘瘤和血管母细胞瘤）的STI之间无显著差异（分别为3.7±1.5和5.0±3.5）。在动态SPECT中，恶性肿瘤的DTI在15分钟内显著增加。相比之下，良性肿瘤的DTI略有增加、稳定或下降。恶性肿瘤组根据DTR计算的线性函数斜率远高于良性肿瘤组（P<0.001）。
我们认为，进行15分钟的201Tl动态SPECT检查有助于鉴别恶性脑肿瘤和良性脑肿瘤，并减轻患者的检查压力。
