[201T1C1 accumulation dynamics in glioma with different grades of malignancy: an investigation using dynamic SPECT]

Dynamic SPECT was performed using 201TICI in a total of 21 gliomas, 14 cases of glioblastoma multiforme (GM) and 7 cases of anaplastic astrocytoma (AA), to investigate the relationship between test results and malignancy. The accumulation of isotope (counts/pixel) in the tumor was measured every 3 minutes with dynamic SPECT. The initial 3-minute value was reduced from subsequent accumulations (counts/minute) to obtain the time-activity curve (TAC). Thallium index (TL index), the ratio of 15-minute accumulation in the tumor to that in the same region of the contralateral normal brain, was also calculated. TL index was significantly higher (p < 0.05, Mann-Whitney test) in GM (6.25 +/- 1.97) than in AA (4.10 +/- 1.66), although no clear differential value could be determined between the two. TAC in the GM group showed that compared with the initial 3-minute value, accumulation increased significantly (p < 0.05) at every measurement point after isotope injection: 6 minutes, 0.660 +/- 0.671; 9 minutes, 1.322 +/- 1.319; 12 minutes, 1.315 +/- 1.632 and 15 minutes, 1.234 +/- 1.552. The increase in isotope accumulation in the tumor after 6 minutes or later was noted in 11 of the 14 cases in the GM group. In the AA group, however, there were no significant differences between the initial 3-minute value and value after 6 minutes (-0.283 +/- 0.462), 9 minutes (-0.574 +/- 0.681), 12 minutes (-0.690 +/- 0.611) and 15 minutes (-0.707 +/- 0.636) after isotope injection. A decrease in isotope accumulation in the tumor after 6 minutes or later was noted in 6 of the 7 cases in the AA group. Compared with static SPECT, dynamic SPECT, which can be performed easily and quickly, is more useful in clinical settings because of its high ability to differentiate the grade of malignancy of gliomas.