Preoperative grading of glioma malignancy with thallium-201 single-photon emission CT: comparison with conventional CT

Kristina Källén, M Heiling, A M Andersson, Arne Brun, Stig Holtås, Erik Ryding

Research output: Contribution to journalArticlepeer-review

Abstract

PURPOSE: To compare thallium-201 single-photon emission CT with conventional CT in grading the malignancy of gliomas and to determine the reliability of each in tumor assessment. METHODS: We studied 37 patients who had gliomas (31 high grade and 6 low grade) and compared the CT findings with the thallium-201 index, which we defined as tumor uptake relative to the uptake in the contralateral hemisphere. RESULTS: Among the high-grade gliomas, we observed a significant correlation between breakdown volume of the blood-brain barrier and thallium-201 uptake. However, 8 of the high-grade gliomas had low thallium-201 uptake, in the same range as the low-grade gliomas. Of these, 2 were nonenhancing and the other 6 showed ring enhancement on CT scans. Analysis of variance showed no significant difference in thallium-201 indexes between low-grade gliomas and highly malignant (grade II-III) gliomas. Accuracy of thallium-201 imaging was lower (78%) than that of CT (84%) in identifying high-grade gliomas. CONCLUSIONS: Damage to the blood-brain barrier is a prerequisite for uptake of thallium-201 in gliomas. Tumors with central necrotic areas and moderate ring enhancement tend to be underestimated when evaluated by means of thallium-201 scintigraphy. The results indicate a need for caution when interpreting findings on images obtained with thallium-201 single-photon emission CT in preoperative evaluation of brain tumors.
Original languageEnglish
Pages (from-to)925-932
JournalAJNR
Volume17
Issue number5
Publication statusPublished - 1996

Bibliographical note

The information about affiliations in this record was updated in December 2015.
The record was previously connected to the following departments: Clinical Neurophysiology (013013001), Diagnostic Radiology, (Lund) (013038000), Neurosurgery (013026000), Pathology, (Lund) (013030000), Neurology, Lund (013027000)

Subject classification (UKÄ)

  • Neurology

Keywords

  • Glioma
  • Brain neoplasms
  • computed tomography
  • Single-photon emission computed tomography

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