대한핵의학회지 (The Korean Journal of Nuclear Medicine)

대한핵의학회 (The Korean Society of Nuclear Medicine)
권호 표지

Thallium-201 SPECT 뇌종양 영상

Thallium-201 SPECT Imaging of Brain Tumors

  • 김상은 (서울대학교 의과대학 내과학교실) ;
  • 최창운 (서울대학교 의과대학 내과학교실) ;
  • 이동수 (서울대학교 의과대학 내과학교실) ;
  • 정준기 (서울대학교 의과대학 내과학교실) ;
  • 이명철 (서울대학교 의과대학 내과학교실) ;
  • 고창순 (서울대학교 의과대학 내과학교실) ;
  • 윤병우 (서울대학교 의과대학 신경과학교실) ;
  • 노재규 (서울대학교 의과대학 신경과학교실) ;
  • 정희원 (서울대학교 의과대학 신경외과학교실)
  • Kim, Sang-Eun (Department of Internal Medicine, Seoul National University, College of Medicine) ;
  • Choi, Chang-Woon (Department of Internal Medicine, Seoul National University, College of Medicine) ;
  • Lee, Dong-Soo (Department of Internal Medicine, Seoul National University, College of Medicine) ;
  • Chung, June-Key (Department of Internal Medicine, Seoul National University, College of Medicine) ;
  • Lee, Myung-Chul (Department of Internal Medicine, Seoul National University, College of Medicine) ;
  • Koh, Chang-Soon (Department of Internal Medicine, Seoul National University, College of Medicine) ;
  • Yoon, Byung-Woo (Department of Neurology, Seoul National University, College of Medicine) ;
  • Roh, Jae-Kyu (Department of Neurology, Seoul National University, College of Medicine) ;
  • Jung, Hee-Won (Department of Neurosurgery, Seoul National University, College of Medicine)
  • 발행 : 1992.05.31
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초록

Thallium-201 $(^{201}T1)$ SPECT studies were performed on a normal volunteer and 12 patients with intracerebral lesions: 3 patients with gliomas, 3 patients with meningiomas, 1 patient each with metastatic tumor, brain abscess, and cerebral infarction, and 3 postirradiation patients. (2 with metastatic tumors, 1 with lymphoma). A $^{201}T1$ index, based on the ratio of $^{201}T1$ uptake in the brain lesion versus the homologous contralateral brain, was calculated and compared with tumor histology and CT/MRI findings. The SPECT $^{201}T1$ scan showed minimal uptake of tracer in a normal brain. There was substantial uptake of $^{201}T1$ in high-grade gliomas (index>1.5) with little uptake in low-grade lesions. A previously irradiated patient with recurrent astrocytoma, in whom MRI study was unable to distinguish tumor recurrence from necrosis, showed the lesions with high $^{201}T1$ indices in both hemispheric regions (2.50/1.93), suggesting tumor recurrence. Two meningiomas and a metastatic tumor showed varying degrees of $^{201}T1$ uptake (index $1.71\sim8.15$), revealing that $^{201}T1$ uptake is not exclusive to high-grade gliomas. In 2 postirradiation patients with metastatic tumors, no abnormal $^{201}T1$ uptake was found in the cerebral lesions, shortly after the initiation of radiation therapy or despite the persistence of enhancing lesions-though improved-on MR images, suggesting that $^{201}T1$ uptake may reflect the metabolic and possibly clonogenic activities of tumors and the brain $^{201}T1$ SPECT imaging might be valuable for the evaluation of tumor responsiveness to the therapy and for early detection of tumor recurrence. A patient with brain abscess on antibiotic treatment, showig increased uptake of $^{201}T1$ in the resolving lesions (index 2.87/1.52) is discussed. In a patient with cerebral infarction, there was no abnormal uptake of $^{201}T1$ in infarcted tissue. When using a threshold index of 1.5, correlation rate between $^{201}T1$ uptake and contrast enhancement of the cerebral lesions on CT/MRI was 73% (8/11). In conclusion, the brain $^{201}T1$ SPECT imaging may be useful for assessment of tumor response to the therapy and to predict low-or high-grade lesions.

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