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Evaluation of malignancy in ring enhancing brain lesions on CT by thallium-201 SPECT

Källén, Kristina LU ; Heiling, M ; Andersson, Ann-Margret LU ; Brun, Arne LU ; Holtås, Stig LU ; Ryding, Erik LU and Rosén, Ingmar LU (1997) In Journal of Neurology, Neurosurgery and Psychiatry 63(5). p.569-574
Abstract
OBJECTIVE: To investigate patients with cystic enhancing lesions on CT and to determine whether thallium-201 (201Tl) SPECT adds to further preoperative information in differential diagnosis between gliomas and abscesses. METHODS: Twenty one patients with cystic ring enhancing CT findings were studied and uptake indices were compared with CT enhancement volumes, histopathology, and survival times. RESULTS: Fourteen high grade gliomas, three low grade gliomas, and four abscesses were found. Uptake was higher in the highly malignant glioma group (median thallium index (TI)=2.1), than in the low grade glioma group (median TI=1.4) or among the abscesses (median TI=1.6). Overlapping indices were found between high and low malignant cystic... (More)
OBJECTIVE: To investigate patients with cystic enhancing lesions on CT and to determine whether thallium-201 (201Tl) SPECT adds to further preoperative information in differential diagnosis between gliomas and abscesses. METHODS: Twenty one patients with cystic ring enhancing CT findings were studied and uptake indices were compared with CT enhancement volumes, histopathology, and survival times. RESULTS: Fourteen high grade gliomas, three low grade gliomas, and four abscesses were found. Uptake was higher in the highly malignant glioma group (median thallium index (TI)=2.1), than in the low grade glioma group (median TI=1.4) or among the abscesses (median TI=1.6). Overlapping indices were found between high and low malignant cystic gliomas as well as between either one of the glioma groups and the infectious lesions, and there were no significant differences between groups. There was a level at the value 2, where TI > or = 2 correlated with tumour diagnosis. One low grade tumour had an extremely high index and a very high enhancement volume. Indices correlated significantly with CT enhancement volumes (P=0.005). There was no significant correlation between Tl indices and patient survival times among the high grade gliomas. One patient with a highly malignant tumour but low Tl uptake < 2, had a survival > five years. CONCLUSIONS: It is concluded that high 201Tl uptake in enhancing cystic lesions is an indicator of highly malignant glioma. However, the differentiation between the high malignant gliomas and abscesses or low malignant gliomas by 201TL SPECT is only partial with an overlap between these groups. (Less)
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author
; ; ; ; ; and
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
cystic brain lesions, computed tomography, glioma, abscesses, single photon emission computed tomography, thallium-201, survival time
in
Journal of Neurology, Neurosurgery and Psychiatry
volume
63
issue
5
pages
569 - 574
publisher
BMJ Publishing Group
external identifiers
  • pmid:9408094
  • scopus:0030715630
ISSN
1468-330X
language
English
LU publication?
yes
additional info
The information about affiliations in this record was updated in December 2015. The record was previously connected to the following departments: Clinical Neurophysiology (013013001), Diagnostic Radiology, (Lund) (013038000), Pathology, (Lund) (013030000), Neurology, Lund (013027000)
id
77a13022-cb85-4c66-90f7-f42590df58b7 (old id 1111452)
alternative location
http://jnnp.bmj.com/cgi/content/full/63/5/569
date added to LUP
2016-04-01 16:24:45
date last changed
2022-01-28 19:33:59
@article{77a13022-cb85-4c66-90f7-f42590df58b7,
  abstract     = {{OBJECTIVE: To investigate patients with cystic enhancing lesions on CT and to determine whether thallium-201 (201Tl) SPECT adds to further preoperative information in differential diagnosis between gliomas and abscesses. METHODS: Twenty one patients with cystic ring enhancing CT findings were studied and uptake indices were compared with CT enhancement volumes, histopathology, and survival times. RESULTS: Fourteen high grade gliomas, three low grade gliomas, and four abscesses were found. Uptake was higher in the highly malignant glioma group (median thallium index (TI)=2.1), than in the low grade glioma group (median TI=1.4) or among the abscesses (median TI=1.6). Overlapping indices were found between high and low malignant cystic gliomas as well as between either one of the glioma groups and the infectious lesions, and there were no significant differences between groups. There was a level at the value 2, where TI &gt; or = 2 correlated with tumour diagnosis. One low grade tumour had an extremely high index and a very high enhancement volume. Indices correlated significantly with CT enhancement volumes (P=0.005). There was no significant correlation between Tl indices and patient survival times among the high grade gliomas. One patient with a highly malignant tumour but low Tl uptake &lt; 2, had a survival &gt; five years. CONCLUSIONS: It is concluded that high 201Tl uptake in enhancing cystic lesions is an indicator of highly malignant glioma. However, the differentiation between the high malignant gliomas and abscesses or low malignant gliomas by 201TL SPECT is only partial with an overlap between these groups.}},
  author       = {{Källén, Kristina and Heiling, M and Andersson, Ann-Margret and Brun, Arne and Holtås, Stig and Ryding, Erik and Rosén, Ingmar}},
  issn         = {{1468-330X}},
  keywords     = {{cystic brain lesions; computed tomography; glioma; abscesses; single photon emission computed tomography; thallium-201; survival time}},
  language     = {{eng}},
  number       = {{5}},
  pages        = {{569--574}},
  publisher    = {{BMJ Publishing Group}},
  series       = {{Journal of Neurology, Neurosurgery and Psychiatry}},
  title        = {{Evaluation of malignancy in ring enhancing brain lesions on CT by thallium-201 SPECT}},
  url          = {{http://jnnp.bmj.com/cgi/content/full/63/5/569}},
  volume       = {{63}},
  year         = {{1997}},
}