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Thallium-201 brain tumor imaging: a comparative study with pathologic correlation.

W D Kaplan, T Takvorian, J H Morris

    Journal of Nuclear Medicine : Official Publication, Society of Nuclear Medicine
    |January 1, 1987
    PubMed
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    Thallium-201 (201Tl) scans better reflect viable glioma tumor burden than other radionuclide imaging. These scans are minimally affected by steroids and complement CT scans for brain tumor assessment.

    Area of Science:

    • Nuclear Medicine
    • Oncology
    • Radiology

    Background:

    • Discrepancies between clinical status and CT scans in glioma patients suggest limitations in assessing tumor viability.
    • Accurate assessment of viable tumor is crucial for treatment planning and prognosis in glioma patients.

    Purpose of the Study:

    • To compare the accuracy of Thallium-201 (201Tl), Technetium-99m gluceptate (GH), and Gallium-67 (67Ga) radionuclide imaging in assessing viable tumor burden in glioma patients.
    • To evaluate the impact of steroid administration on radionuclide scan results.
    • To determine how radionuclide imaging complements computed tomography (CT) in glioma evaluation.

    Main Methods:

    • Prospective study of 29 glioma patients undergoing sequential 201Tl, 99mTc GH, and 67Ga scans.
    • Correlation of imaging findings with neuropathologic data in seven deceased patients.

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  • Analysis of scan results in 22 patients without autopsy data, comparing radionuclide uptake patterns with CT findings.

    • Main Results:

    • 201Tl scans showed the most accurate correlation with viable tumor in patients with autopsy data.
    • 67Ga scans yielded similar results to 201Tl in patients not receiving steroids.
    • 99mTc GH and CT scans could not reliably differentiate between tumor, necrosis, and edema.
    • 201Tl scans demonstrated smaller, more focal abnormal uptake compared to 99mTc GH and 67Ga scans in patients without autopsy data.

    Conclusions:

    • 201Tl scintigraphy is superior to other radionuclide methods for reflecting viable tumor burden in primary brain tumors.
    • 201Tl scans are minimally affected by steroid use and can be performed rapidly.
    • 201Tl imaging complements CT scans by providing functional information on tumor viability.