Nadel H R
Department of Radiology, British Columbia's Children's Hospital, Vancouver, Canada.
Semin Nucl Med. 1993 Jul;23(3):243-54. doi: 10.1016/s0001-2998(05)80105-9.
Many pediatric centers are beginning to accumulate a large experience in the use of thallium-201 (201Tl) imaging with 201Tl requires a state-of-the-art high-resolution gamma camera computer system with single photon emission computed tomography (SPECT) capability and a physician-directed tailored examination. Tumor imaging with 201Tl, with its multifactorial localization mechanisms that are different from those for gallium-67, offers a distinct advantage over gallium tumor imaging with a short total imaging time. Tumors are variable in avidity and intensity of thallium uptake. Primary and metastatic disease can be detected with 201Tl scintigraphy. Baseline pretreatment determination of thallium avidity is crucial to its efficacy in therapeutic response assessment. Adjunctive SPECT imaging provides greater sensitivity for lesion detection and direct comparison of physiology (thallium uptake) with anatomy (computed tomography and magnetic resonance imaging). The sensitivity and specificity for detection of pediatric brain tumors has been reported as 77% and 93%, respectively. Thallium-201 brain SPECT also provides a less expensive and more readily available alternative to positron emission tomography for assessing the functional state of pediatric brain tumors. Extremity osteogenic sarcoma and Ewing's sarcoma have 100% sensitivity for 201Tl uptake pretreatment. Early results confirm an association between 201Tl uptake and histological tumor response. The determination of residual/recurrent disease versus thymic rebound and other nonneoplastic change in thallium-avid lymphoma, rhabdomyosarcoma, and germ cell tumors that involve the thorax can be confirmed with a 201Tl SPECT examination. Soft-tissue tumors elsewhere in the body may be detected with 201Tl scintigraphy. Thallium-201 does not exhibit 100% specificity for tumors. False-positive 201Tl uptake has been seen in histiocytosis X, benign bone tumors, stress fractures, and inflammation.
许多儿科中心在使用铊 - 201（²⁰¹Tl）成像方面开始积累丰富经验，²⁰¹Tl成像需要具备单光子发射计算机断层扫描（SPECT）功能的先进高分辨率伽马相机计算机系统以及由医生指导的定制检查。²⁰¹Tl肿瘤成像具有与镓 - 67不同的多因素定位机制，与镓肿瘤成像相比，其总成像时间短，具有明显优势。肿瘤对铊的摄取亲和力和强度各不相同。原发性和转移性疾病都可用²⁰¹Tl闪烁扫描检测。治疗前对铊摄取的基线测定对于其在治疗反应评估中的疗效至关重要。辅助性SPECT成像对病变检测具有更高的灵敏度，并且能将生理学（铊摄取）与解剖学（计算机断层扫描和磁共振成像）进行直接比较。据报道，检测小儿脑肿瘤的灵敏度和特异性分别为77%和93%。²⁰¹Tl脑SPECT在评估小儿脑肿瘤功能状态方面也为正电子发射断层扫描提供了一种成本更低且更容易获得的替代方法。肢体骨肉瘤和尤因肉瘤对²⁰¹Tl摄取预处理的灵敏度为100%。早期结果证实了²⁰¹Tl摄取与肿瘤组织学反应之间的关联。通过²⁰¹Tl SPECT检查可以确定累及胸部的铊摄取性淋巴瘤、横纹肌肉瘤和生殖细胞瘤中残留/复发性疾病与胸腺反弹及其他非肿瘤性变化的情况。身体其他部位的软组织肿瘤可用²⁰¹Tl闪烁扫描检测。²⁰¹Tl对肿瘤并不具有100%的特异性。在组织细胞增多症X、良性骨肿瘤、应力性骨折和炎症中可见²⁰¹Tl摄取假阳性。
