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Does supplementation of contrast MR imaging with thallium-201 brain SPECT improve differentiation between benign and malignant ring-like contrast-enhanced cerebral lesions?

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Abstract

Objective

To determine whether thallium-201 (201Tl) brain single photon emission computed tomography (SPECT) could supplement magnetic resonance (MR) imaging diagnostic information by visual comparison of two separate data sets from patients with ring-like contrast-enhanced cerebral lesions.

Methods

A combination of MR imaging and 201Tl brain SPECT sets obtained from 13 patients (10 men, 3 women) ranging in age from 26 years to 86 years (mean 61.0 years) were retrospectively reviewed. A total of 12 patients had a solitary lesion, and the others had multiple lesions. All but two intracranial foci were pathologically confirmed. The final diagnoses were six glioblastomas, two cerebral metastases from lung cancer, and one each of abscess, resolving hematoma, primary central nervous system lymphoma, toxoplasmosis, and radiation necrosis. The two separate image formats (MR images and SPECT) were shown to ten readers with practical experience. All of the MR images for each patient were shown to each reader first. After interpreting them, the readers were shown the SPECT images. Images were scored in terms of how benign or malignant the foci were on a 5-point scale from “definitely benign” to “definitely malignant.”

Results

The improvement in the performance of all ten readers was from 67.7% to 93.8% in mean accuracy (P = 0.0028) and from 0.730 to 0.971 in mean Az value (P = 0.0069) after they were shown the 201Tl brain SPECT images.

Conclusions

201Tl brain SPECT should substantially increase confidence in the diagnosis of intracranial lesions with ring-like contrast enhancement when MR imaging does not permit differentiation between benign and malignant disease.

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Authors and Affiliations

  1. Department of Radiology, National Defense Medical College, 3-2 Namiki, Tokorozawa, 359-8513, Japan

    Tamotsu Kita, Katsumi Hayashi, Masayoshi Yamamoto, Toshio Kawauchi, Ikuko Sakata, Yoshie Iwasaki & Shigeru Kosuda

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  1. Tamotsu Kita
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  2. Katsumi Hayashi
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  3. Masayoshi Yamamoto
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  4. Toshio Kawauchi
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  5. Ikuko Sakata
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  6. Yoshie Iwasaki
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  7. Shigeru Kosuda
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Correspondence to Shigeru Kosuda.

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Kita, T., Hayashi, K., Yamamoto, M. et al. Does supplementation of contrast MR imaging with thallium-201 brain SPECT improve differentiation between benign and malignant ring-like contrast-enhanced cerebral lesions?. Ann Nucl Med 21, 251–256 (2007). https://doi.org/10.1007/s12149-007-0026-y

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  • DOI: https://doi.org/10.1007/s12149-007-0026-y

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