De La Peña R C, Ketonen L, Villanueva-Meyer J
Department of Radiology, Nuclear Medicine and Neuroradiology Sections, University of Texas Medical Branch at Galveston, USA.
Eur J Nucl Med. 1998 Oct;25(10):1404-11. doi: 10.1007/s002590050315.
Our aim was to evaluate the use of dual-isotope thallium-201 (Tl) and technetium-99m sestamibi (sestamibi) simultaneous acquisition in brain single-photon emission tomography (SPET) for the differentiation between brain lymphoma and benign central nervous system (CNS) lesions in AIDS patients. Thirty-six consecutive patients with enhancing mass lesions on magnetic resonance (MR) imaging were included in the study. SPET of the brain was performed to obtain simultaneous Tl and sestamibi images. Regions-of-interest were drawn around the lesion and on the contralateral side to calculate uptake ratios. The final diagnosis was reached by pathologic findings in 17 patients and clinical and/or MR follow-up in 19 patients. Of the 36 patients, 11 had brain lymphoma, 1 glioblastoma multiforme, 15 toxoplasmosis and 9 other benign CNS lesions. Correlation between SPET and the final diagnosis revealed in 10 true-positive, 23 true-negative, 1 false-positive and 2 false-negative studies. All patients with toxoplasmosis had negative scans. A patient with a purulent infection had positive scans. Tl and sestamibi scans were concordant in every lesion. The same lesions that took up Tl were also visualized with sestamibi. However, sestamibi scans showed higher lesion-to-normal tissue uptake ratios (3.7 +/- 1.8) compared with those of Tl (2.3 +/- 0.8, P < 0.002). Simultaneous acquisition of Tl and sestamibi can help differentiate CNS lymphoma from benign brain lesions in AIDS patients.
我们的目的是评估在脑单光子发射断层扫描（SPET）中使用双同位素铊-201（Tl）和锝-99m 甲氧基异丁基异腈（sestamibi）同时采集，以鉴别艾滋病患者的脑淋巴瘤与良性中枢神经系统（CNS）病变。本研究纳入了 36 例磁共振（MR）成像显示有强化肿块病变的连续患者。进行脑部 SPET 以获得 Tl 和 sestamibi 的同步图像。在病变及其对侧绘制感兴趣区以计算摄取率。17 例患者通过病理结果得出最终诊断，19 例患者通过临床和/或 MR 随访得出最终诊断。36 例患者中，11 例患有脑淋巴瘤，1 例为多形性胶质母细胞瘤，15 例为弓形虫病，9 例为其他良性 CNS 病变。SPET 与最终诊断之间的相关性显示，有 10 例真阳性、23 例真阴性、1 例假阳性和 2 例假阴性研究。所有弓形虫病患者扫描均为阴性。1 例化脓性感染患者扫描为阳性。Tl 和 sestamibi 扫描在每个病变中均一致。摄取 Tl 的相同病变也能用 sestamibi 显示。然而，与 Tl 相比，sestamibi 扫描显示病变与正常组织的摄取率更高（3.7±1.8），而 Tl 为（2.3±0.8，P<0.002）。同时采集 Tl 和 sestamibi 有助于鉴别艾滋病患者的 CNS 淋巴瘤与良性脑病变。
