Diagnosis of recurrent brain tumor: value of 201Tl SPECT vs 18F-fluorodeoxyglucose PET.

Kahn, Daniel; Follett, Kenneth A.; Bushnell, D. L.; Nathan, Mark A.; Piper, J. G.; Madsen, Mark T.; Kirchner, Peter T.

doi:10.2214/ajr.163.6.7992747

Cited by 138 publications

(53 citation statements)

References 4 publications

(4 reference statements)

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“…But later studies, in 1990's, showed that value of this technique in distinguishing between post-therapeutical changes and brain tumor recurrences could be limited, because of lower specificity. [20,21,22] Recent studies have reported the sensitivity and specificity of 18 FDG/PET in differentiation of radiation injury from tumor recurrences between 81% to 100 % and 40% to 100 % respectively, greatly depending on primary tumor pathologic grade. Causes of false-positive results include recent radiation therapy, nonmalignant inflammatory processes and subclinical seizure activity.…”

Section: Discussionmentioning

confidence: 99%

Post-therapeutical changes in the brain: novel trends in imaging and their infuence on external beam radiotherapy

Chorváth¹,

Bolješíková²,

Pruzincová³

et al. 2009

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Presented is the analysis of patients who underwent external beam radiotherapy (EBRT) to the brain in the period from 2003 to 2006 at the department of Radiation Oncology of the St. Elisabeth Cancer Institute.The aim of our analysis was to identify risk factors of late delayed therapy induced injuries (LDTI) in the brain. The patients were regularly examined with magnetic resonance (MRI), including conventional and advanced techniques: perfusion imaging (pMRI), diffusion weighted imaging (DWI), MRI spectroscopy (MRS). The results from MRI were correlated with 18 fluoro-deoxyglucose positron emission tomography ( 18 FDG/PET) scans, as none of the listed method is sufficiently sensitive and specific by itself. Also clinical data records and treatment plans of these patients were analyzed.In our cohort we found 6 patients with abnormal post-therapeutical changes, 4 of them with MR and 18 FDG/PET scans characteristics for LDTI -radiation necrosis. In one patient biopsy was performed and radiation necrosis (RN) was confirmed.

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Section: Discussionmentioning

confidence: 99%

Post-therapeutical changes in the brain: novel trends in imaging and their infuence on external beam radiotherapy

Chorváth¹,

Bolješíková²,

Pruzincová³

et al. 2009

neo

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“…Several studies investigating the potential of 18 F-FDG in discriminating tumor recurrence and RN have been performed. However, equivocal results with sensitivities and specificities ranging from 40 to 100% were published (21,28,34,(46)(47)(48). Besides the high and variable uptake by the normal cortex, radiation injury can activate repair mechanisms or lead to inflammation, which can lead to false-positive results (20).…”

Section: Pet For Therapy Response Assessment In Gbmentioning

confidence: 99%

“…Finally, 18 F-FCho PET was assumed to be promising in differentiating GB from RN (47,52,97). 18 F-FCho PET was studied in patients with solitary brain lesions and correctly identified patients with RN based on LNR (87).…”

Section: F-fluoromethylcholine ( F-fcho)mentioning

confidence: 99%

PET for Therapy Response Assessment in Glioblastoma

et al. 2017

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Glioblastoma (GB) is the most malignant and the most common type of glioma in adults, accounting for 60-70% of all malignant gliomas. Despite the current therapy, the clinical course of GB is usually rapid, with a mean survival time of approximately 1 year. For therapy response assessment in GB, magnetic resonance imaging (MRI) is the method of choice. In 2010, the Response Assessment in Neuro-Oncology (RANO) was introduced, including the tumor size (in 2D) as measured on T2-weighted and Fluid Attenuated Inversion Recovery (FLAIR)-weighted images, in addition to the contrast-enhancing tumor part. Although the RANO criteria addressed some of the limitations of the previous MacDonald criteria for therapy evaluation in high-grade glioma, treatment-related side effects hamper correct response assessment. To address the above-mentioned drawbacks in the follow-up of GB, incorporating changes in tumor biology measured by advanced MRI and positron emission tomography (PET) imaging, which may precede anatomical changes of the tumor volume, is promising. Imaging biomarkers capable of predicting response at an early time point after treatment initiation are the premise of personalized treatment enabling change or GB Treatment Response Using PET 176 discontinuation of therapy to prevent ineffective treatment or adverse events of treatment. In this chapter, an overview of applicable PET tracers for the therapy response assessment in GB and the determination of tumor recurrence versus treatment-related effects is given.

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“…[4] Functional imaging with thallium-201 (Tl-201) single-photon emission computerized tomography (SPECT) has recently been reported to be useful in predicting the presence and location of recurrent brain tumor after debulking and radiation treatment. [1,15,16,21,22,29,35] This technique has been found to be equal in accuracy to fluorine-18 deoxyglucose positron emission tomography for this purpose. [1,15] The radioisotope Tl-201 is a potassium analog that requires a disrupted blood-brain barrier (BBB) to gain access to the brain and is then taken up in proportion to the activity of the sodium-potassium adenosine triphosphatase pump.…”

mentioning

confidence: 96%

“…[1,15,16,21,22,29,35] This technique has been found to be equal in accuracy to fluorine-18 deoxyglucose positron emission tomography for this purpose. [1,15] The radioisotope Tl-201 is a potassium analog that requires a disrupted blood-brain barrier (BBB) to gain access to the brain and is then taken up in proportion to the activity of the sodium-potassium adenosine triphosphatase pump. Previous reports that analyzed survival as a function of Tl-201 uptake in small populations did not analyze either the pattern of recurrence or the original tumor grade.…”

mentioning

confidence: 96%

Dual isotope single-photon emission computerized tomography used for prediction of histology and survival in patients after high-dose radiotherapy for malignant astrocytoma

Schwartz¹,

Holman²,

Garada³

et al. 1996

FOC

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This study was conducted to determine the sensitivity of dual-isotope single-photon emission computerized tomography (SPECT) in predicting tumor recurrence and survival in patients treated with high-dose radiotherapy for malignant gliomas. Studies using SPECT with thallium-201 (Tl-201) and technetium-99m (Tc-99m) hexamethypropyleneamine oxime (HMPAO) in 50 consecutive patients with malignant astrocytomas treated by surgery and high-dose radiotherapy were performed 1 day before reoperation. Maximum uptake of Tl-201 in the lesion was expressed as a ratio to that of the contralateral scalp, and uptake of Tc-99m HMPAO was expressed as a ratio to that of the cerebellar cortex. Patients were stratified into groups based on maximum radioisotope uptake values in their tumor beds. Differences in tumor histopathology at reoperation and 1-year survival between SPECT groups were determined by using chi-square analysis. The majority of patients in Group IA (Tl-201 ratio less than 2 or Tc-99m HMPAO ratio less than 0.5) showed radiation changes in their biopsy specimens (85.7%); they had an 85.7% 1-year survival rate. Group II (Tl-201 ratio between 2 and 3.5) had predominantly infiltrating tumor (78.6%); they had a 42% 1-year survival rate. Almost all of the patients in Group III (Tl-201 ratio greater than 3.5) had solid tumor (93.3%) and they had a 6.7% 1-year survival. Survival and pathological data differed significantly among groups (p less than 0.009). Dual-isotope SPECT data correlates with histological findings on reoperation and postoperative survival in patients with malignant gliomas.

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Diagnosis of recurrent brain tumor: value of 201Tl SPECT vs 18F-fluorodeoxyglucose PET.

Cited by 138 publications

References 4 publications

Post-therapeutical changes in the brain: novel trends in imaging and their infuence on external beam radiotherapy

Post-therapeutical changes in the brain: novel trends in imaging and their infuence on external beam radiotherapy

PET for Therapy Response Assessment in Glioblastoma

Dual isotope single-photon emission computerized tomography used for prediction of histology and survival in patients after high-dose radiotherapy for malignant astrocytoma

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