Nagai Hidemasa, Haramoto Masuo, Takada Daikei, Daisu Mituhiro, Miyazaki Takeshi, Sugimoto Keiji, Akiyama Yasuhiko, Moritake Kouzo, Yamamoto Yasushi
Department of Neurosurgery, Shimane University Faculty of Medicine, 89-1 Enya, Izumo-shi, Shimane 693-8501, Japan.
No Shinkei Geka. 2008 Dec;36(12):1093-101.
201Tl-SPECT (single photon emission computed tomography) had a disadvantage of low spatial resolution with a limited ROI (region of interest) setting. Recently, the diagnosis of brain tumors has been improved by fusion-imaging employing MRI (magnetic resonance imaging) with Tl-SPECT. In order to assess the usefulness of MR-fusion Tl-SPECT quantitatively, we have compared non-fusion (NF) and MR-fusion (MR-F) imaging with Tl-SEPCT in patients with brain tumors. A total of 38 patients (M/F=14/24) hospitalized at our institution during a 5-year period, each with a histologically confirmed brain tumor, were studied. The index of Tl was used for the early ratio (ER), delayed ratio (DR), and retention index (RI), There was no significant difference between NF and MR-F, which were examined using the test-retest method by 2 observers (N&H), but the Pearson's correlation coefficient was higher for MR-F than for NF. The RI value for MR-F was significantly correlated with the WHO histological grading (r=0.605, n=38, p<0.00l). The DR value for MR-F was significantly correlated with MIB-1 index (r=0.464, n=24, p=0.022). We estimated the RI cut-off value for both NF and MR-F in malignancy by ROC analysis. A cut-off value of RI=0.63 and RI=0.70 was good for NF and MR-F, respectively. The likelihood ratio (LR) of RI was higher for MR-F (LR=6.897) than for NF (LR=2.978), suggesting that RI=0.7 for MR-F was suitable for diagnosis of malignant brain tumor. We conclude that MR-fusion Tl-SPECT is better for quantitative analysis of brain tumors than non-fusion Tl-SPECT.
201铊单光子发射计算机断层扫描（201Tl-SPECT）存在空间分辨率低且感兴趣区（ROI）设置受限的缺点。最近，通过将磁共振成像（MRI）与铊单光子发射计算机断层扫描进行融合成像，脑肿瘤的诊断得到了改善。为了定量评估磁共振融合铊单光子发射计算机断层扫描（MR-fusion Tl-SPECT）的实用性，我们比较了脑肿瘤患者非融合（NF）成像和磁共振融合（MR-F）成像与铊单光子发射计算机断层扫描（Tl-SEPCT）的情况。在5年期间，共有38例在我们机构住院的患者（男/女 = 14/24）接受了研究，每例患者均经组织学确诊患有脑肿瘤。铊的指标用于计算早期比值（ER）、延迟比值（DR）和滞留指数（RI）。由2名观察者（N和H）采用重测法对NF和MR-F进行检查，二者之间无显著差异，但MR-F的皮尔逊相关系数高于NF。MR-F的RI值与世界卫生组织组织学分级显著相关（r = 0.605，n = 38，p < 0.001）。MR-F的DR值与MIB-1指数显著相关（r = 0.464，n = 24，p = 0.022）。我们通过ROC分析估计了NF和MR-F在恶性肿瘤中的RI临界值。RI = 0.63和RI = 0.70分别是NF和MR-F的良好临界值。MR-F的RI似然比（LR）（LR = 6.897）高于NF（LR = 2.978），表明MR-F的RI = 0.7适用于恶性脑肿瘤的诊断。我们得出结论，与非融合铊单光子发射计算机断层扫描相比，磁共振融合铊单光子发射计算机断层扫描在脑肿瘤定量分析方面表现更佳。
