TY - JOUR
T1 - Relationship between thallium-201 uptake by supratentorial glioblastomas and their morphological characteristics on magnetic resonance imaging
AU - Ricci, Monica
AU - Pantano, Patrizia
AU - Pierallini, Alberto
AU - Di Stefano, Domenica
AU - Santoro, Antonio
AU - Bozzao, Luigi
AU - Lenzi, Gian Luigi
PY - 1996
Y1 - 1996
N2 - Single-photon emission tomography (SPET) with thallium-201 is used in the assessment of patients with gliomas because the amount of
201Tl accumulated by the tumoral cells increases in proportion to the degree of tumour malignancy, thus making it possible to differentiate high-grade from low-grade gliomas or recurrences from radiation necrosis. However, in large areas of tissue such as those examined in
201Tl SPET studies, the uptake of
201Tl may vary considerably even in tumours with the same histological diagnosis, as occurs in glioblastomas (GBMs). In order to evaluate the possible influence of the macroscopic characteristics of tumours on
201Tl uptake, we studied a series of 13 patients with histologically proven GBMs, comparing magnetic resonance imaging (MRI) parameters such as tumour dimensions, perilesional oedema, intratumoral necrosis and contrast enhancement with the degree of
201Tl uptake. The patients underwent both
201Tl SPET and MRI before surgery. The
201Tl index (tumour/contralateral unaffected brain) was calculated using two different region of interest (ROI) methods: the first employed irregular large ROIs (3.2 ± 13.9 cm
2) including pixels with more than 50% maximum activity; the second employed regular square small ROIs (2.7 cm
2) centered on the maximum activity of the lesion. Of the MRI morphological parameters studied, only necrosis significantly reduced the degree of
201Tl uptake in GBMs when larger ROIs were used. However, by using small regular ROIs the influence of necrosis on
201Tl uptake was found to be less relevant. Since necrosis is related to tumour proliferative activity and represents a negative prognostic factor in astrocytoma, a possible underestimation of
201Tl uptake due to intratumoral necrosis must be carefully evaluated.
AB - Single-photon emission tomography (SPET) with thallium-201 is used in the assessment of patients with gliomas because the amount of
201Tl accumulated by the tumoral cells increases in proportion to the degree of tumour malignancy, thus making it possible to differentiate high-grade from low-grade gliomas or recurrences from radiation necrosis. However, in large areas of tissue such as those examined in
201Tl SPET studies, the uptake of
201Tl may vary considerably even in tumours with the same histological diagnosis, as occurs in glioblastomas (GBMs). In order to evaluate the possible influence of the macroscopic characteristics of tumours on
201Tl uptake, we studied a series of 13 patients with histologically proven GBMs, comparing magnetic resonance imaging (MRI) parameters such as tumour dimensions, perilesional oedema, intratumoral necrosis and contrast enhancement with the degree of
201Tl uptake. The patients underwent both
201Tl SPET and MRI before surgery. The
201Tl index (tumour/contralateral unaffected brain) was calculated using two different region of interest (ROI) methods: the first employed irregular large ROIs (3.2 ± 13.9 cm
2) including pixels with more than 50% maximum activity; the second employed regular square small ROIs (2.7 cm
2) centered on the maximum activity of the lesion. Of the MRI morphological parameters studied, only necrosis significantly reduced the degree of
201Tl uptake in GBMs when larger ROIs were used. However, by using small regular ROIs the influence of necrosis on
201Tl uptake was found to be less relevant. Since necrosis is related to tumour proliferative activity and represents a negative prognostic factor in astrocytoma, a possible underestimation of
201Tl uptake due to intratumoral necrosis must be carefully evaluated.
KW - Glioblastoma
KW - Magnetic resonance imaging
KW - Neuro-oncology
KW - Thallium-201 single-photon emission tomography
KW - Tumoral necrosis
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M3 - Article
C2 - 8698056
AN - SCOPUS:0029971222
VL - 23
SP - 524
EP - 529
JO - European Journal of Pediatrics
JF - European Journal of Pediatrics
SN - 0340-6199
IS - 5
ER -