Variation in Appearance of Glioma on Serial Thallium-201 Single Photon Emission Computed Tomography : Case Report

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A 63-year-old female presented with recurrent glioblastoma at the site of a right parietal glioblastoma which was diagnosed 1 year before. She was treated at that time by total removal of the tumor, irradiation, and chemotherapy. Four months after the initial treatment, serial thallium-201 single photon emission computed tomography (^<201>Tl SPECT) showed increased uptake at the edge of the original tumor site. The index, the ratio of ^<201>Tl uptake in the lesion to the normal brain, was 2.9 which suggested a recurrent tumor. Magnetic resonance images with gadolinium over the next 7 months demonstrated an enhanced mass lesion at the site of primary tumor resection and a new enhanced mass in the right temporal lobe. The lesion in the right parietal lobe had a ^<201>Tl uptake index of 2.5, while the lesion in the right temporal lobe had an index of 1.5. Re-craniotomy and total resection of the tumors in the right parietal and temporal lobes were performed. The histological diagnosis of both tumors was glioblastoma. The proposed use of ^<201>Tl SPECT for the differential diagnosis of recurrent glioma and radiation necrosis should be carefully considered because the ^<201>Tl uptake index can vary in tumor with the same malignancy grade.
日本脳神経外科学会の論文
1995-05-15