Comparative value of thallium and glucose SPECT imaging in childhood brain tumors

• Published in: Pediatric neurology Vol. 19; no. 5; pp. 351 - 357
• Main Authors: Maria, Bernard L, Drane, Walter E, Mastin, Suzanne T, Jimenez, Luis A
• Format: Journal Article
• Language: English
• Published: New York, NY Elsevier Inc 01-11-1998; Elsevier
• Subjects: Biological and medical sciences; Brain Neoplasms - diagnostic imaging; Brain Neoplasms - pathology; Child; False Negative Reactions; Fluorodeoxyglucose F18; Humans; Medical sciences; Necrosis; Neoplasm Recurrence, Local - diagnostic imaging; Neoplasm, Residual - diagnostic imaging; Neurology; Predictive Value of Tests; Radiation Injuries - diagnostic imaging; Radiopharmaceuticals; Sensitivity and Specificity; Thallium Radioisotopes; Tomography, Emission-Computed, Single-Photon; Tumors of the nervous system. Phacomatoses; Radionuclide study; Human; Performance evaluation; Intracranial; Thallium; Nervous system diseases; Exploration; Glucose; Photon; Cerebral disorder; Central nervous system disease; Tumor; Child; Comparative study; Emission tomography
• ISSN: 0887-8994; 1873-5150
• DOI: 10.1016/S0887-8994(98)00083-6

Thallium-201 chloride (
201Tl) single-photon emission computed tomography (SPECT) detects a high percentage of histologically and anatomically diverse pediatric brain tumors. Thallium-201 chloride SPECT and F-18 fluoro-deoxy-glucose (
18F-FDG) positron emission tomography (PET) are the most commonly used radionuclide techniques in neuro-oncology. Having developed a methodology to image
18F-FDG with SPECT, the authors performed SPECT scans coupled with magnetic resonance imaging to assess the comparative sensitivity of
201Tl and
18F-FDG in 19 children with brain tumors. Tumors were detected using
201Tl SPECT in 14 of 19 patients. Five of five postoperative residual tumors were detected by
201Tl SPECT, and six of seven after irradiation recurrences were detected. F-18 fluoro-deoxy-glucose SPECT detected tumors in only three of 19 patients, all of whom had abnormal
201Tl studies (all three after therapy recurrences). Thallium-201 chloride SPECT could be interpreted in 18 of 19 patients without magnetic resonance imaging confirmation, but none of the 19
18F-FDG SPECT studies could be interpreted without magnetic resonance imaging. Thallium-201 chloride SPECT is more sensitive than
18F-FDG SPECT in the detection of primary or recurrent childhood brain tumors. The failure of
18F-FDG SPECT in follow-up after therapy is primarily a problem of limited fluoro-deoxy-glucose uptake, not spatial resolution. Thallium-201 chloride SPECT is a promising imaging modality in neuro-oncology.