Elsevier

Pediatric Neurology

Volume 7, Issue 4, July–August 1991, Pages 249-257
Pediatric Neurology

201Tl/99mTc-HMPAO SPECT imaging of treated childhood brain tumors

https://doi.org/10.1016/0887-8994(91)90040-RGet rights and content

Abstract

To assess whether thallium-201 thallous chloride (Tl) can detect childhood tumors and whether diagnostic effectiveness improves with combined blood flow imaging, 28 children (1.0–18.6 years) were studied using single photon emission computed tomography (SPECT): Tl (1.3–1.8 mCi intravenously), followed in 13 of the patients by technetium-99m-hexamethylpro-pyleneamine oxime (99mTc-HMPAO; 8–18 mCi intravenously). Tl-uptake was markedly increased with histologically confirmed recurrent brain tumors ( N = 12). Tl-avid tumors comprised several histologic types, including 6 astrocytomas/gliomas as well as nonastrocytic neoplasms, such as medulloblastoma and ependymoma. A questionable false-positive study was observed with a treated medulloblastoma. Tl failed to detect 5 tumors (i.e., 2 medulloblastomas, 1 ependymoma, 1 malignant schwannoma, and initially 1 lowgrade astrocytoma). The sensitivity and specificity of201Tl-SPECT for detection of childhood brain tumors was 76.9% and 93.3%, respectively. The mean tumorto-normal brain ratio for Tl was 2.5 ± 0.5 ( N = 7). In some of the patients,201Tl-SPECT allowed a more precise assessment of the functional state of the tumor than was possible with computed tomography and magnetic resonance imaging. HMPAO distribution was variously normal, increased or decreased at the site of tissue abnormality, and abnormal blood flow was demonstrated in the remaining neuraxis, in 3 of the 7 patients. Changes in tissue perfusion did not correlate with Tl findings, but were evaluated in only one false-negative study.

Reference (31)

  • AncriD et al.

    Diagnosis of cerebral lesions by thallium 201

    Radiology

    (1978)
  • KaplanWD et al.

    Thallium-201 brain tumor imaging: A comparative study with pathologic correlation

    J Nucl Med

    (1987)
  • AtkinsHL et al.

    Thallium-201 for medical use, part 3: Human distribution and physical imaging properties

    J Nucl Med

    (1977)
  • MountzJM et al.

    Thallium-201 tumor/cardiac ratio estimation of residual astrocytoma

    J Neurosurg

    (1988)
  • BlackKL et al.

    Use of thallium-201 SPECT to quantify malignancy grade of gliomas

    J Neurosurg

    (1989)
  • Cited by (0)

    View full text