Skip to main content
SpringerLink
Log in

Thallium-201 SPECT in prognostic assessment of malignant gliomas treated with postoperative radiotherapy

  • Original Article
  • Published:
Annals of Nuclear Medicine Aims and scope Submit manuscript

Abstract

Objective

This study was designed to investigate the value of preoperative thallium-201 (201Tl) SPECT as a predictor of outcome in malignant glioma.

Methods

From January 1990 to September 2003, 109 patients with glioma were treated with postoperative radiotherapy. Of these, 36 patients with malignant gliomas who underwent preoperative201T1-SPECT were included in this study (grade 3: n = 14, grade 4: n = 22). On early (10 minutes) and delayed (2 hours) images after 111 MBq201T1C1 injection, we calculated radioactivity ratios of tumors to contralateral normal brain (T/N ratios) and retention indices (RIs). For early and delayed images, we compared outcome between a high T/N ratio group (T/N ratio equal or greater than the average) and a low T/N ratio group (T/ N ratio less than the average). We also divided the patients into two groups on the basis of RI; a high RI group (RI equal or greater than the average) and a low RI group (RI less than the average), and similarly compared outcome between the two groups. asResults

Median survival time was 12 months for both grade 3 and grade 4 tumors; however, two-year survival was 53% for grade 3 and 15% for grade 4. In both early and delayed images, outcome was significantly better for patients with low T/N ratios (early <4.71, delayed <3.96) than those with high T/N ratios (early: p = 0.030, delayed: p = 0.049). However, no significant survival difference was apparent between the low- (< -12.25) and high RI groups. In grade 3 glioma, patients with high T/N ratios demonstrated a tendency toward poorer outcome, although this trend was not significant (early: p = 0.079, delayed: p = 0.099). Overall outcome was poor for grade 4 glioma, and the difference in survival between low and high T/N ratio groups was not significant (early: p = 0.51, delayed: p = 0.53). However, long survival was seen only in patients with lower T/N ratios.

Conclusions

Differences of201T1 uptake in malignant gliomas could predict outcome.201T1-SPECT is potentially useful in the management of patients with malignant gliomas.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Brandes AA. State-of-the-art treatment of high-grade brain tumors.Semin Oncol 2003; 30 (6 suppl 19): 4–9.

    Article  PubMed  Google Scholar 

  2. Jeremic B, Milicic B, Grujicic D, Dagovic A, Aleksandrovic J. Multivariate analysis of clinical prognostic factors in patients with glioblastoma multiforme treated with a combined modality approach.J Cancer Res Clin Oncol 2003; 129: 477–484.

    Article  PubMed  Google Scholar 

  3. Buckner JC. Factors influencing survival in high-grade gliomas.Semin Oncol 2003; 30 (6 suppl 19): 10–14.

    Article  PubMed  Google Scholar 

  4. Vos MJ, Hoekstra OS, Barkhof F, Berkhof J, Heimans JJ, van Groeningen CJ, et al. Thallium-201 single-photon emission computed tomography as an early predictor of outcome in recurrent glioma.J Clin Oncol 2003; 21: 3559–3565.

    Article  PubMed  Google Scholar 

  5. Lev MH, Ozsunar Y, Henson JW, Rasheed AA, Barest GD, Harsh GR 4th, et al. Glial tumor grading and outcome prediction using dynamic spin-echo MR susceptibility mapping compared with conventional contrast-enhanced MR: confounding effect of elevated rCB V of oligodendro-gliomas.Am J Neuroradiol 2004; 25: 214–221.

    PubMed  Google Scholar 

  6. Tamawski R, Sokol M, Pieniazek P, Maciejewski B, Walecki J, Miszczyk L, et al.1H-MRSin vivo predicts the early treatment outcome of postoperative radiotherapy for malignant gliomas.int J Radiat Oncol BiolPhys 2002; 52: 1271–1276.

    Article  Google Scholar 

  7. Ricci PE. Imaging of adult brain tumors.Neuroimaging Clin N Am 1999; 9: 651–669.

    PubMed  CAS  Google Scholar 

  8. Vallejos V, Balana C, Flaue M. Use of201Tl SPECT imaging to assess the response to therapy in patients with high grade gliomas.J Neurooncol 2002; 59: 81–90.

    Article  PubMed  CAS  Google Scholar 

  9. Nakada K, Katoh C, Kanegae K, Tsukamoto E, Itoh K, Furudate M, et al. The role of201Tl scintigraphy in evaluating proliferative activity in thyroid neoplasms.Ann Nucl Med 1996; 10: 41–48.

    Article  PubMed  CAS  Google Scholar 

  10. Suga K, Kume N, Orihashi N, Nishigauchi K, Uchisako H, Matsumoto T, et al. Difference in201T1 accumulation on single photon emission computed tomography in benign and malignant thoracic lesions.Nucl Med Commun 1993; 14: 1071–1078.

    Article  PubMed  CAS  Google Scholar 

  11. Kaplan WD, Takvorian T, Morris JH, Rumbaugh CL, Connolly BT, Atkins HL. Thallium-201 brain tuor imaging: A comparative study with pathologic correlation.J Nucl Med 1987; 28: 47–52.

    PubMed  CAS  Google Scholar 

  12. Vertosick FT Jr, Selker RG, Grossman SJ, Joyce JM. Correlation of thallium-201 single photon emission computed tomography and survival after treatment failure in patients with glioblastoma multiforme.Neurosurgery 1994; 34: 396–401.

    Article  PubMed  Google Scholar 

  13. Lorberboym M, Mandell LR, Mosesson RE, Germano I, Lou W, DaCosta M, et al. The role of thallium-201 uptake and retention in intracranial tumor after radiotherapy.J Nucl Med 1997; 38: 223–226.

    PubMed  CAS  Google Scholar 

  14. Rodrigues M, Fonseca AT, Salgado D, Vieira MR.99mTc-HMPAO brain SPECT in the evaluation of prognosis after surgical resection of astrocytoma. Comparison with other noninvasive imaging techniques (CT, MRI and201T1 SPECT).Nucl Med Commun 1993; 14: 1050–1060.

    Article  PubMed  CAS  Google Scholar 

  15. Black KL, Emerick T, Hoh C, Hawkins RA, Mazziotta J, Becker DP. Thallium-201 SPECT and positron emission tomography equal predictors of glioma grde and recurrence.Neurol Res 1994; 16: 93–96.

    PubMed  CAS  Google Scholar 

  16. Bénard F, Romsa J, Hustinx R. Imaging gliomas with positron emission tomography and single-photon emission computed tomography.Semin Nucl Med 2003; 33: 148–162.

    Article  PubMed  Google Scholar 

  17. Oriuchi N, Tamura M, Shibazaki T, Ohye C, Watanabe N, Tateno M, et al. Clinical evaluation of thallium-201 SPECT in supratentorial gliomas: Relationship to histologic grade, prognosis and proliferative activities.J Nucl Med 1993; 34: 2085–2089.

    PubMed  CAS  Google Scholar 

  18. Higa T, Maetani S, Kobashi Y, Nabeshima S. T1-201 SPECT compared with histopathologic grade in the prognostic assessment of cerebral gliomas.Clin Nucl Med 200l; 26: 119–124.

    Article  Google Scholar 

  19. Kosuda S, Fujii H, Aoki S, Suzuki K, Tanaka Y, Nakamura O, et al. Prediction of survival in patients with suspected recurrent cerebral tumors by quantitative thallium-201 single photon emission computed tomography.Int J Radiat Oncol Biol Phys 1994; 30: 1201–1206.

    PubMed  CAS  Google Scholar 

  20. Black KL, Hawkins RA, Kim KT, Becker DP, Lerner C, Marciano D. Use of thallium-201 SPECT to quantitate malignancy grade of gliomas.J Neurosurg 1989; 71: 342–346.

    Article  PubMed  CAS  Google Scholar 

  21. Jinnouchi S, Hoshi H, Ohnishi T, Futami S, Nagamachi S, Watanabe K, et al. Thallium-201 SPECT for predicting histological type of meningiomas.J Nucl Med 1993; 34: 2091–2094.

    PubMed  CAS  Google Scholar 

  22. Sun D, Liu Q, Liu W, Hu W. Clinical application of201T1 SPECT imaging of brain tumor.J Nucl Med 2000; 41: 5–10.

    PubMed  CAS  Google Scholar 

  23. Baumert BG, Lutterbach J, Bernays R, Davis JB, Heppner FL. Fractionated stereotactic radiotherapy boost after postoperative radiotherapy in patients with high-grade gliomas.Radiother Oncol 2003; 67: 183–190.

    Article  PubMed  Google Scholar 

  24. Thilmann C, Zabel A, Grosser KH, Hoess A, Wannenmacher M, Debus J. Intensity-modulated radiotherapy with an integrated boost to the macroscopic tumor volume in the treatment of high-grade gliomas.Int J Cancer 2001; 96: 341–349.

    Article  PubMed  CAS  Google Scholar 

  25. Kim S, Chung JK, Im SH, Jeong JM, Lee DS, Kim DG, et al.11C-methionine PET as a prognostic marker in patients with glioma: comparison with18F-FDG PET.Eur J Nucl Med Mol Imaging 2005; 32: 52–59.

    Article  PubMed  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Radiology, Ehime University School of Medicine, 454, Shitsukawa, Toon, 791-0295, Ehime, Japan

    Takatoshi Semba, Yoshifumi Sugawara, Takashi Ochi, Takashi Fujii & Teruhito Mochizuki

  2. Department of Neurosurgery, Ehime University School of Medicine, Japan

    Takanori Ohnishi

Authors
  1. Takatoshi Semba
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Yoshifumi Sugawara
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Takashi Ochi
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Takashi Fujii
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Teruhito Mochizuki
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Takanori Ohnishi
    View author publications

    You can also search for this author in PubMed Google Scholar

Rights and permissions

Reprints and permissions

About this article

Cite this article

Semba, T., Sugawara, Y., Ochi, T. et al. Thallium-201 SPECT in prognostic assessment of malignant gliomas treated with postoperative radiotherapy. Ann Nucl Med 20, 287–294 (2006). https://doi.org/10.1007/BF02984645

Download citation

  • Received:

  • Accepted:

  • Issue Date:

  • DOI: https://doi.org/10.1007/BF02984645

Key words

Search

Navigation