Use of 201Tl SPECT for Evaluation of Biologic Behavior in Pituitary Adenomas

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FIGURE 1.
Calculation of ²⁰¹Tl uptake index. Transverse line was made that passed over tumor, and counts on line were plotted as curve. Maximum count (C_max) of tumor part was divided by mean count of nontumor area (B₁ and B₂).
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FIGURE 2.
(A) Tl^e index was significantly greater in invasive tumor group (mean ± SE, 11.40 ± 2.49) than in noninvasive tumor group (4.26 ± 0.41) (P = 0.0010). (B) Tl^d index was also significantly greater in invasive tumor group (mean ± SE, 6.69 ± 0.71) than in noninvasive tumor group (3.76 ± 0.37) (P = 0.0019).
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FIGURE 3.
Tl^d index correlated significantly with MIB1 labeling index (P = 0.0107). Pearson’s r = 0.527.
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FIGURE 4.
Patient 21. (A) MR coronal T1-weighted image shows macroadenoma that extended bilateral cavernous sinuses. (B) ²⁰¹Tl SPECT early image shows marked concentration of ²⁰¹Tl in tumor. (C) On ²⁰¹Tl SPECT delayed image, ²⁰¹Tl was retained in tumor. (D) Light-microscopic section (×400). MIB1 immunostaining shows relatively high percentage of MIB1-positive cells (arrows).

TABLE 1

Tl Uptake Indices and MIB1 Labeling Indices in Pituitary Adenomas

Patient	Age (y)	Sex	Size (mm)	Invasion	Tl^e index	Tl^d index	MIB1	Function
1	65	M	12 × 18 × 12	−	4.78	3.73	0.61	NF
2	48	F	27 × 22 × 22	−	.40	2.46	0.00	NF
3	18	F	20 × 17 × 23	−	2.70	4.39	0.00	PRL
4	54	F	27 × 20 × 18	−	5.20	4.11	0.00	NF
5	41	M	26 × 22 × 22	−	6.33	2.52	0.00	NF
6	55	F	10 × 7 × 10	−	3.50	3.78	0.10	GH
7	64	F	13 × 11 × 10	−	3.62	4.07	0.10	NF
8	47	F	5 × 5 × 10	−	4.00	2.54	0.80	GH
9	20	M	11 × 9 × 9	−	2.86	3.67	0.10	GH
10	24	M	12 × 10 × 11	−	6.18	6.36	2.10	GH
11	51	M	32 × 28 × 23	+	9.60	5.43	0.00	NF
12	43	M	25 × 20 × 20	+	8.70	5.96	0.00	NF
13	65	F	28 × 17 × 17	+	7.21	7.56	0.90	PRL
14	49	F	24 × 24 × 28	+	7.20	4.62	0.10	NF
15	30	M	40 × 49 × 42	+	37.00	6.33	0.20	NF
16	47	F	40 × 28 × 28	+	3.48	4.48	0.30	NF
17	38	M	47 × 36 × 50	+	11.75	8.24	4.90	PRL
18	36	M	25 × 20 × 13	+	11.47	5.74	0.30	NF
19	37	F	11 × 20 × 27	+	5.05	2.76	0.00	NF
20	40	M	26 × 38 × 39	+	9.34	7.56	1.70	NF
21	62	F	27 × 20 × 27	+	14.00	11.29	2.00	NF
22	61	M	20 × 20 × 25	+	12.04	10.28	0.20	GH