OtherClinical Investigations

Stereotactic Coregistration of 201Tl SPECT and MRI Applied to Brain Tumor Biopsies

Simone Hemm, Valérie Rigau, Jeanine Chevalier, Marie C. Picot, Luc Bauchet, Hassan El Fertit, Marie-Ange Rodriguez, Laura Cif, Nathalie Vayssière, Michel Zanca, Pierre Baldet, François Segnarbieux and Philippe Coubes
Journal of Nuclear Medicine July 2005, 46 (7) 1151-1157;

Article Figures & Data

Figures

  • FIGURE 1.
    FIGURE 1.

    Patient 2: 201Tl sSPECT- and sMRI-guided biopsy. Target level (A–C) and level 29 mm above on trajectory (D–F) are shown on sagittal MRI slices (A and D), axial MRI slices (B and E), and axial 201Tl sSPECT slices (C and F). Coordinates of pixel with highest metabolic activity within tumor on 201Tl sSPECT images (C) were determined and transferred to MR images for usual biopsy planning (A and B). Sampled level 29 mm above target was visualized afterward on sMRI (D and E) and on 201Tl sSPECT slices (F). Histologic analysis revealed grade II (−29 mm) and grade III oligoastrocytoma (target).

  • FIGURE 2.
    FIGURE 2.

    Patient 7: 201Tl sSPECT- and sMRI-guided biopsy. Target level (A–C) and level 5 mm above on trajectory (D–F) are shown on sagittal MRI slices (A and D), axial MRI slices (B and E), and axial 201Tl sSPECT slices (C and F). Histologic analysis revealed anaplastic astrocytoma (grade III) in both samples.

  • FIGURE 3.
    FIGURE 3.

    Evolution of thallium index (TI), MI, Ki67 index (KiI), and tumor grade on trajectory for patient 8 (n = 6 samples).

  • FIGURE 4.
    FIGURE 4.

    Mean values of thallium index (TI), MI, Ki67 index (KiI), and tumor grade on trajectory for all patients. Samples were divided into 4 classes: class 1: x = 0 mm (target); class 2: 0 mm < |x| ≤ 5 mm; class 3: 5 mm < |x| ≤ 10 mm; and class 4: |x| > 10 mm.

Tables

  • TABLE 1

    Histologic and Image Analysis of Brain Tumor Samples from 10 Patients

    Patient no.Distance of sample from target (mm)Micronecrosis index (%)Target 201TI indexTarget WHO tumor gradeTarget Ki67 index (%)Target MI
    1*−10, −5, 0100 (3/3)1.2Astrocytoma IINecrosisNecrosis
    −5, 050 (1/2)2.0Astrocytoma II21
    2−29, −16, −10, −5, 0, +125 (2/8)3.7Oligoastrocytoma III5212
    3−20, −17.5, −15, −9, −5, 0, +575 (2/8)4.1Glioblastoma IVNecrosisNecrosis
    4*−10, −5, 00 (0/3)3.9Glioblastoma IV2410
    −5, 00 (0/2)5.5Glioblastoma IV258
    5−20, −15, −10, −5, 0, +5, +100 (0/7)6.2Anaplastic oligodendroglioma III133
    6−10, −5, 0, +5, +100 (0/5)10.0Neuroendocrine metastasis5910
    7−9, −5, 00 (0/3)8.25Anaplastic astrocytoma III407
    8−18, −12, −10, −5, 0, +50 (0/6)3.67Glioblastoma IV8027
    9−30, −20, −15, −10, −5, 00 (0/5)3.30Oligodendroglioma III564
    10−8, 0, +5, +10, +150 (0/5)6.17Glioblastoma multiform IV5251

    • ↵* Two different trajectories were analyzed for this patient.

    • MI = mitotic index.

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