Nose Ayumi, Otsuka Hideki, Nose Hayato, Otomi Yoichi, Terazawa Kaori, Harada Masafumi
Department of Radiology, Tokushima University Hospital, Tokushima, Japan.
J Med Invest. 2013;60(1-2):121-6. doi: 10.2152/jmi.60.121.
To evaluate the usefulness of (201)Tl-SPECT in differentiating benign from malignant brain tumors.
Eighty-eight patients (44 males and 44 females) with 58 high-grade (WHO grade III-IV) and 30 low-grade (WHO grade I-II) tumors were evaluated with (201)Tl-SPECT. (1) Visual assessment was performed by board-certificated radiologists using (201)Tl-SPECT. Tumors were classified in two groups (Tl-positive and Tl-negative) and scored using the five grade evaluation system. Receiver operating characteristic (ROC) analysis was performed in the Tl-positive group. (2) Semi-quantitative assessment involved measurement of early and delayed (201)Tl uptake, and the retention index (RI) was applied as follows: RI=delayed uptake ratio/early uptake ratio. Three combinations of RI using mean and maximum values of the region of interest were calculated.
(1) Seventy-four Tl-positive and 14 Tl-negative tumors. The area under the ROC curve (AUC) estimated by three radiologists exceeded a value of 0.7. The value was greater when estimated by the more experienced radiologist. (2) In all RIs, the difference of RI between high-grade tumors and low-grade tumors was statistically significant.
A visual and semi-quantitative assessment using (201)Tl-SPECT was found to be useful for differentiating benign from malignant brain tumors.
评估201铊单光子发射计算机断层扫描（201Tl-SPECT）在鉴别脑肿瘤良恶性方面的效用。
对88例患者（44例男性和44例女性）进行了201Tl-SPECT评估，这些患者患有58例高级别（世界卫生组织III-IV级）和30例低级别（世界卫生组织I-II级）肿瘤。（1）由具备专业资格认证的放射科医生通过201Tl-SPECT进行视觉评估。将肿瘤分为两组（Tl阳性和Tl阴性），并使用五级评估系统进行评分。对Tl阳性组进行受试者操作特征（ROC）分析。（2）半定量评估包括测量早期和延迟的201Tl摄取，并应用滞留指数（RI）如下：RI = 延迟摄取率/早期摄取率。计算了使用感兴趣区域的平均值和最大值的RI的三种组合。
（1）74例Tl阳性肿瘤和14例Tl阴性肿瘤。三位放射科医生估计的ROC曲线下面积（AUC）超过0.7。经验更丰富的放射科医生估计的值更大。（2）在所有RI中，高级别肿瘤和低级别肿瘤之间的RI差异具有统计学意义。
发现使用201Tl-SPECT进行视觉和半定量评估有助于鉴别脑肿瘤的良恶性。
