Relationship between thallium-201 uptake by supratentorial glioblastomas and their morphological characteristics on magnetic resonance imaging

Monica Ricci, Patrizia Pantano, Alberto Pierallini, Domenica Di Stefano, Antonio Santoro, Luigi Bozzao, Gian Luigi Lenzi

Research output: Contribution to journalArticle

Abstract

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.

Original languageEnglish
Pages (from-to)524-529
Number of pages6
JournalEuropean Journal Of Nuclear Medicine
Volume23
Issue number5
Publication statusPublished - 1996

Fingerprint

Thallium
Glioblastoma
Magnetic Resonance Imaging
Necrosis
Photons
Neoplasms
Tomography
Glioma
Astrocytoma
Edema
Radiation
Recurrence
Brain

Keywords

  • Glioblastoma
  • Magnetic resonance imaging
  • Neuro-oncology
  • Thallium-201 single-photon emission tomography
  • Tumoral necrosis

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging

Cite this

Relationship between thallium-201 uptake by supratentorial glioblastomas and their morphological characteristics on magnetic resonance imaging. / Ricci, Monica; Pantano, Patrizia; Pierallini, Alberto; Di Stefano, Domenica; Santoro, Antonio; Bozzao, Luigi; Lenzi, Gian Luigi.

In: European Journal Of Nuclear Medicine, Vol. 23, No. 5, 1996, p. 524-529.

Research output: Contribution to journalArticle

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