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

Abstract

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.

13N-NH3 Versus F-18 FDG in Detection of Intracranial Meningioma

“…4). 13 N-NH 3 uptake in meningiomas was biphasic, with a rapid increase during the first 30 seconds after tracer administration followed by a slower increase during the remaining examination time. The displaying of the tumors was synchronous to that of the internal carotid artery, and the radioactivity in the tumors markedly exceeded surrounding brain radioactivity during the examination time.…”

“…[11][12][13] There are 2 chemical forms of ammonia (NH 3 and NH 4 ϩ ) in the blood. The relative proportion of NH 3 and NH 4 ϩ in blood is determined by the pH.…”

“…13 N was prepared by the 16 O (p, a) 13 N nuclear reaction in a water target with the Cyclone-10/5 cyclotron (IBA). The target water was added to a reaction vessel containing Devarda's alloy and NaOH pellets to reduce oxides of 13 N to ammonia gas.…”

“…Relatively high Tl-201 uptakes were found in all types of meningiomas, and 201 TlCl SPECT could predict histologic types of meningiomas and differentiate the benign and aggressive meningiomas. [11][12][13] However, a major drawback of 201 TlCl SPECT is its difficulty in detecting small meningiomas and quantifying the dynamic bio distribution of Tl-201 in the tumors because SPECTs spatial and temporal resolutions are limited for brain imaging.…”

“…14 Like Tl-201, 13 N-NH 4 ϩ could substitute K ϩ in some cases. [15][16] We have reported that there was a substantial uptake of 13 N-NH 3 in cerebral astrocytomas, and 13 N-NH 3 was a promising tracer for separating radiation necrosis from astrocytoma recurrence and suggested to be a potential contrast-enhanced tracer being more sensitive and specific for diagnosing brain tumor than Gd-DTPA, and may prove especially useful for evaluating the contrast-enhancing lesions on MRI to distinguish brain tumors from non-neoplastic lesions.…”