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Clinical Application of ²⁰¹Tl SPECT Imaging of Brain Tumors

Nuclear Medicine and Neurosurgery Departments, The Second Hospital of the Medical College, Zhejiang University, Hangzhou, People's Republic of China

Correspondence: For correspondence or reprints contact: Da Sun, MD, Nuclear Medicine Department, The Second Hospital of the Medical College, Zhejiang University, Hangzhou, 310009 People's Republic of China.

ABSTRACT

This study investigated the clinical usefulness of evaluating the histologic grade of brain tumors by ²⁰¹Tl SPECT brain imaging. Methods: Early and delayed SPECT brain images were obtained about 10 min and 3 h, respectively, after intravenous injection of 111MBq (3 mCi) ²⁰¹Tl in 9 healthy subjects (control subjects), 3 patients with brain hematomas, and 41 patients with brain tumors. Semiquantitative data were obtained for early and delayed ²⁰¹Tl uptake indices and ²⁰¹Tl retained index in all patients and healthy subjects. Results: In 9 healthy subjects, there was little radioactivity in brain substance. In all patients with brain hematomas or tumors, a high tracer uptake was visible in lesions on early images, but the radioactivity in lesions varied with the histologic nature of the lesion on delayed images. The radioactivity decreased remarkably in brain hematomas (average retained index, 0.61 ± 0.04). The radioactivity was stable or decreased slightly in benign or low-grade tumors (average retained index, 0.96 ± 0.24). The radioactivity was increased in high-grade or metastatic tumors (average retained index, 1.26 ± 028). Conclusion: This study indicates that ²⁰¹Tl brain SPECT early and delayed imaging is very useful in brain tumor localization, in distinguishing low-grade from high-grade brain tumors, in predicting histologic grades of brain tumors, and in detecting residual or recurrence of brain tumors postoperatively. ²⁰¹Tl brain SPECT may also offer the most accurate assessment of response to therapy.

Key Words: ²⁰¹Tl SPECT • brain tumor • ²⁰¹Tl retained index

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