DETECTION OF RECURRENT GLIOMAS WITH QUANTITATIVE TL-201 TC-99M HMPAO SINGLE-PHOTON EMISSION COMPUTERIZED-TOMOGRAPHY
DETECTION OF RECURRENT GLIOMAS WITH QUANTITATIVE TL-201 TC-99M HMPAO SINGLE-PHOTON EMISSION COMPUTERIZED-TOMOGRAPHY
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DOI：
10.3171/jns.1992.77.4.0565
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发表时间：
1992-10-01
影响因子：
4.1
通讯作者：
HOLMAN, BL
中科院分区：
文献类型：
--
作者：
CARVALHO, PA;SCHWARTZ, RB;HOLMAN, BL
高级别胶质瘤高剂量放射治疗后临床状态恶化可能是由于放射变化或可能是复发或残留肿瘤肿块的信号。这两种情况不能通过计算机断层扫描（CT）或磁共振（MR）成像可靠地区分。作者评估了序贯氯化铊-201（Tl-210）和锝-99 m六甲基丙烯胺肟（Tc-99 m HMPAO）单光子发射CT（SPECT）区分恶性胶质瘤高剂量（大于或等于600 cGy）放射治疗后肿瘤复发与放射变化的能力。对32例患者术前肿瘤/非肿瘤摄取率进行分析，并与再次手术时大体肿瘤的存在相关，在13例Tl-201肿瘤/头皮比率为3.5或更高的患者中，有12例存在复发肿瘤。作者发现Tc-99 m HMPAO SPECT可用于识别低至中度Tl-201摄取（比值1.1至3.4）和该部位低灌注患者的实体瘤复发。在12例Tc-99 mHMPAO肿瘤/小脑比值为0.50或更低的患者中，有11例没有复发肿瘤。Tl-201比率为3.4或更低且Tc-99 m HMPAO比率为0.51或更高的7名患者中有3名在手术时发现肿瘤复发;因此该测试在该组中不具有预测性。它的结论是，使用连续的Tl-201和Tc-99 m HMPAO SPECT准确地识别肿瘤复发与放射性变化的存在下，在大多数高级别星形细胞瘤谁经历了肿瘤切除术和高剂量放射治疗的患者。
Deteriorating clinical status after high-dose radiation therapy for high-grade gliomas may be due to radiation changes or may signal recurrent or residual tumor mass. The two conditions cannot be distinguished reliably by computerized tomography (CT) or magnetic resonance (MR) imaging. The authors assessed the ability of sequential thallium-201 chloride (Tl-210) and technetium-99m hexamethylpropylene amine oxime (Tc-99m HMPAO) single-photon emission CT (SPECT) to distinguish tumor recurrence from radiation changes after high-dose (greater-than-or-equal-to 600 cGy) radiation therapy for malignant gliomas. Preoperative tumor/nontumor uptake ratios were analyzed in 32 patients and correlated with the presence of gross tumor at the time of reoperation.In 12 of 13 patients with Tl-201 tumor/scalp ratios of 3.5 or greater, recurrent tumor was present. The authors found Tc-99m HMPAO SPECT to be useful for identifying the absence of solid tumor recurrence in patients with low to moderate Tl-201 uptake (ratio 1.1 to 3.4) and low perfusion to that site. In 11 of 12 patients with Tc-99m HMPAO tumor/cerebellum ratios of 0.50 or less, no recurrent tumor mass was present. Three of seven patients with Tl-201 ratios of 3.4 or less and Tc-99m HMPAO ratios of 0.51 or more had recurrent tumor found at surgery; thus the test.was not predictive in this group. It is concluded that the use of sequential Tl-201 and Tc-99m HMPAO SPECT accurately identifies the presence of tumor recurrence versus radiation changes in most patients with high-grade astrocytomas who have undergone tumor resection and high-dose radiation therapy.