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Potential usefulness of Tl-201 SPECT for differentiating radionecrosis in an irradiated nasopharyngeal carcinoma patient

  • Head and Neck Oncology
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European Archives of Oto-Rhino-Laryngology and Head & Neck Aims and scope Submit manuscript

Abstract

Differentiation between cerebral radionecrosis and intracranial relapse in irradiated nasopharyngeal carcinoma (NPC) patients challenges the clinicians, especially when clinical manifestation and MRI findings are inconclusive. A 63-year-old NPC patient had intermittent dizziness and unsteady gait 3 years after irradiation. An ice water caloric test revealed absent response on the right ear, which was compatible with an enhanced lesion at the right temporal lobe on MRI scan. Furthermore, abnormal focally increased uptake over the anteriomedial aspect of the right temporal lobe was disclosed on 18-fluoro-2-deoxyglucose (FDG) positron emission tomography (PET), which suggested intracranial relapse. Conversely, serological study for Epstein-Barr viral titer was within normal limits, arguing against either recurrent or metastatic NPC. Hence, thallium (Tl)-201 single photon emission computed tomography (SPECT) was subsequently conducted, which failed to demonstrate abnormal thallium accumulation in the corresponding area. Accordingly, radiation necrosis of the temporal lobe rather than intracranial relapse is considered. The patient was rather well without locoregional recurrence or distant metastasis 2 years after presentation.

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Acknowledgements

This work was supported by the National Science Council grant NSC 93-2314-B002-114, Taipei, Taiwan.

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Authors and Affiliations

  1. Department of Otolaryngology, National Taiwan University Hospital of the National Taiwan University College of Medicine, 1 Chang-Te St, Taipei, Taiwan

    Chi-Te Wang & Yi-Ho Young

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  1. Chi-Te Wang
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  2. Yi-Ho Young
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Correspondence to Yi-Ho Young.

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Wang, CT., Young, YH. Potential usefulness of Tl-201 SPECT for differentiating radionecrosis in an irradiated nasopharyngeal carcinoma patient. Eur Arch Otorhinolaryngol 263, 135–138 (2006). https://doi.org/10.1007/s00405-005-0964-8

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  • DOI: https://doi.org/10.1007/s00405-005-0964-8

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