Early Effects of Gamma Knife Radiosurgery on Brain Metastases : Assessment by ^lt201gtTICI SPECT and ^lt99mgtTc-DTPA-Human Serum Albumin SPECT

概要

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Thallium-201 chloride (^lt201gtTICI) single photon emission computed tomography (SPECT) was used to determine tumor viability, and the early and delayed images of technetium-99m-diethylenetriaminepenta-acetic acid-human serum albumin (^lt99mgtTc-HSA-D) SPECT were used to assess tumor vascularity and permeability, respectively, in 17 patients with 18 brain metastases. SPECT was performed before, 1 week after, and 1 month after radiosurgery. The ratios of ^lt201gtTl and ^lt99mgtTc-HSA-D uptake in a tumor were expressed as a ratio to uptake in the corresponding normal contralateral areas (uptake index). Magnetic resonance imaging with gadolinium was used to determine tumor volume. ^lt201gtTl index decreased significantly 1 week (p lt 0.05) and 1 month (p lt 0.005) after radiosurgery. In contrast, ^lt99mgtTc-HSA-D indices of early and delayed images obtained at 1 week after radiosurgery were not significantly different from the pretreatment values. However, both were significantly low (p lt 0.05) 1 month after radiosurgery. No change in tumor volume was detected 1 week following radiosurgery, but there was a significant decrease (p lt 0.005) after 1 month. The reduction in tumor viability that occurs before the appearance of evidence of tumor shrinkage represents the early effect of radiosurgery on brain metastases. Reduction in tumor size, vascularity, and permeability occur subsequently.
日本脳神経外科学会の論文
1997-01-15