Lorberboym M, Baram J, Feibel M, Hercbergs A, Lieberman L
Department of Nuclear Medicine, Sheba Medical Center, Tel Hashomer, Israel.
Int J Radiat Oncol Biol Phys. 1995 Apr 30;32(1):249-54. doi: 10.1016/0360-3016(95)00580-R.
The follow-up of patients with malignant brain tumors after surgery, radiation, and/or chemotherapy has been inadequate for evaluating brain tumor burden using computerized tomography (CT) or magnetic resonance imaging (MRI). Thallium-201 has been shown to concentrate in viable tumor, and Tl-201 single photon emission computerized tomography (SPECT) imaging can identify tumor burden more accurately than CT.
Thirty-one patients with glioblastoma and three patients with low grade astrocytoma were studied with Tl-201 SPECT. Histololgic diagnosis was obtained in all patients by biopsy and all patients had CT scans within 2 weeks of the SPECT study. Seventeen patients were followed with one or more SPECT and CT evaluations.
Single photon emission computerized tomography studies, after surgery, radiotherapy, and/or chemotherapy, were more accurate than CT in identifying progression or regression of disease. Twenty-three patients had evidence of disease and 11 patients had no evidence of recurrent disease in the initial Tl-201 SPECT study following therapy. Computerized tomography identified 20 of the 23 patients with disease and 6 of 11 patients with no recurrent disease. Follow-up with Tl-201 SPECT in 17 patients suggested progression of disease in 9 patients, while CT showed progression in only 3 patients. Clinical examinations and repeat CT studies confirmed the accuracy of Tl-201 SPECT images.
We found Tl-201 SPECT more accurate than CT scans in a prospective evaluation of 34 patients with brain tumor. Follow-up studies with both Tl-201 SPECT and CT imaging in 17 patients demonstrated that SPECT was more reliable than CT in identifying progression, improvement, or no change in brain tumor burden.
对于接受手术、放疗和/或化疗后的恶性脑肿瘤患者，采用计算机断层扫描（CT）或磁共振成像（MRI）来评估脑肿瘤负荷的随访工作一直存在不足。已证实铊-201会在存活肿瘤中聚集，并且铊-201单光子发射计算机断层扫描（SPECT）成像比CT能更准确地识别肿瘤负荷。
对31例胶质母细胞瘤患者和3例低级别星形细胞瘤患者进行了铊-201 SPECT研究。所有患者均通过活检获得组织学诊断，并且所有患者在SPECT研究的2周内均进行了CT扫描。17例患者接受了一次或多次SPECT和CT评估随访。
在识别疾病进展或消退方面，手术后、放疗后和/或化疗后的单光子发射计算机断层扫描研究比CT更准确。在治疗后的首次铊-201 SPECT研究中，23例患者有疾病证据，11例患者无复发疾病证据。CT识别出23例有疾病患者中的20例以及11例无复发疾病患者中的6例。对17例患者进行铊-201 SPECT随访提示9例患者疾病进展，而CT仅显示3例患者进展。临床检查和重复CT研究证实了铊-201 SPECT图像的准确性。
我们发现，在对34例脑肿瘤患者进行的前瞻性评估中，铊-201 SPECT比CT扫描更准确。对17例患者同时进行铊-201 SPECT和CT成像的随访研究表明，在识别脑肿瘤负荷的进展、改善或无变化方面，SPECT比CT更可靠。
