201Tl SPET in the differential diagnosis of brain tumours

A 32-year-old female presented with a rare case of pituitary abscess manifesting as homonymous hemianopsia. Serum prolactin level was slightly high (40.8 ng/ml). Magnetic resonance (MR) imaging showed the content of the lesion as homogeneously isointense on the T 1 -weighted images and hyperintense on the T 2 -weighted images. The capsule of the lesion, which appeared thin and smooth, was enhanced by gadolinium. Dural enhancement around the sella turcica was also recognized. Thallium-201 single photon emission computed tomography ( 201 Tl SPECT) showed homogeneous high accumulation in the pituitary region on both the early and delayed images. The lesion was treated via a transnasaltranssphenoidal approach. The cystic lesion contained pus and the capsule consisted of normal pituitary gland with inflammatory changes. The patient was treated with antibiotics for 3 weeks and the pituitary abscess was cured completely. Pituitary abscess can be differentiated from pituitary adenoma as lesion with a homogeneous high uptake on 201 Tl SPECT on both the early and delayed images, and no enhancement of the central portion on MR images.

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Pituitary Abscess Showing High Uptake of Thallium-201 on Single Photon Emission Computed Tomography. Case Report.

Shimamura

Ogane

Takahashi

et al. 2003

“…201 Tl Cl uptake is correlated with malignancy or proliferative potential in brain tumors. 5,11,15,24,29,35) The retention of 201 Tl as measured by 201 Tl Cl SPECT is predictive of the malignant potential in meningiomas. 16) Technetium-99m sestamibi ( 99m Tc-MIBI), a lipophilic radiopharmaceutical, was developed as an alternative to 201 Tl for myocardial perfusion imaging, and is known to be taken up by various types of tumors including brain tumors.…”

Section: Introductionmentioning

confidence: 99%

Technetium-99m Sestamibi Single Photon Emission Computed Tomography Findings Correlated With P-glycoprotein Expression, Encoded by the Multidrug Resistance Gene-1 Messenger Ribonucleic Acid, in Intracranial Meningiomas

Kunishio

Morisaki

Matsumoto

et al. 2003

The present study evaluated whether technetium-99m sestamibi ( 99m Tc-MIBI) single photon emission computed tomography (SPECT) characteristics of intracranial meningioma are correlated with the histological malignancy, proliferative potential, and P-glycoprotein (Pgp) expression, encoded by the multidrug resistance gene-1 (MDR-1) messenger ribonucleic acid (mRNA). Twenty-one patients with intracranial meningiomas, including 17 benign and four nonbenign meningiomas, underwent 99m Tc-MIBI SPECT imaging at 15 minutes (early) and 3 hours (delayed) after injection. The tumor-to-normal pituitary gland ratio was calculated on both early (ER) and delayed (DR) images. Retention index (RI) was calculated using the following formula: (DR -ER)/ER × 100%. Meningioma specimens were examined by immunohistochemistry using anti-Pgp and MIB-1 monoclonal antibody. MDR-1 mRNA expression was also investigated using reverse transcription-polymerase chain reaction assay. 99m Tc-MIBI was highly accumulated and retained in the tumors. 99m Tc-MIBI SPECT findings were not related to MIB-1 labeling index. 99m Tc-MIBI SPECT RI of the Pgp-positive group (-9.12 ± 22.27%) was significantly lower than that of the Pgp-negative group (28.79 ± 22.80%) (p ＝ 0.0016). No significant difference was seen in ER and DR between the positive and negative groups. These results show that 99m Tc-MIBI may not be useful for determining proliferative potential and histological malignancy, but could predict anticancer drug resistance related to the expression of MDR-1 mRNA and its gene product Pgp in patients with intracranial meningiomas.

“…11,14,16,17,19,[22][23][24][25]28,29) Thallium index is usually calculated as the ratio of counts in the lesion to the normal brain, and is 201 Tl is very high in the delayed phase in meningothelial meningioma. 13) The thallium kinetics of other intracranial tumors should be considered in the differential diagnosis of fourth ventricle meningioma.…”

Section: Discussionmentioning

confidence: 99%

“…The thallium retention rate 29) glioblastoma (14) low grade glioma (7) brain metastasis (7) meningioma (2) 3. 24) metastasis (16) glioblastoma (15) 17) hemangioblastoma (9) glioma (including grades II and III) (6) metastasis (1) …”

Section: Discussionmentioning

confidence: 99%

Usefulness of Thallium-201 Chloride Single Photon Emission Computed Tomography for the Preoperative Diagnosis of Fourth Ventricle Meningioma-Case Report-

Ooigawa

Miyazawa

Otani

et al. 2004

A 51-year-old woman presented with a fourth ventricle meningioma manifesting as a 2-week history of dizziness and vomiting. Computed tomography (CT) and magnetic resonance (MR) imaging revealed a round mass lesion in the fourth ventricle. Thallium-201 chloride single photon emission computed tomography ( 201 TlCl SPECT) showed high and rapid uptake on the early image and rapid washout on the delayed image. The preoperative diagnosis of meningioma could be established based on these findings. Total removal of the tumor was successfully performed. 201 TlCl SPECT is useful for the preoperative diagnosis of fourth ventricle meningioma combined with CT, MR imaging, and angiography.