Extraosseous accumulation of bone scanning agents in malignant brain tumors

Comparison to semi-quantitative evaluation with 99mTc SPECT/201Tl SPECT and histological findings

Aya Suzuki, Takashi Togawa, Junpei Kuyama, Tadaki Nakahara, Toshihiko Iuchi, Masaru Oga, Katsunobu Osato, Toshinao Takenouchi

Research output: Contribution to journalArticle

7 Citations (Scopus)

Abstract

Although 201Tl chloride (Tl) SPECT has been used in the differential diagnosis between recurrence of malignant brain tumor and necrosis after treatment, it is not generally recognized as a definite modality to distinguish them. We conducted a preliminary study using Tl SPECT and 99mTc-MDP or 99mTc-HMDP (Tc) SPECT because it has been said that extraosseous accumulation was caused by calcium deposits in necrotic tissues. In our study, for the purposes of clarifying the mechanism of extraosseous uptake and the correlation between extraosseous accumulation of bone-scanning agent and tumor viability in malignant brain tumors, we compared whether Tc uptake was correlated with the histopathological findings and further performed semi-quantitative evaluation between Tc SPECT and Tl SPECT. The correlation coefficients between the ratio of tumor to normal skull count obtained from Tc SPECT (Tc-T/N) and those of tumor to normal brain count (T/N) and to normal scalp count (T/S) both obtained from Tl SPECT were calculated. Using contrast enhanced CT (CE-CT) or contrast enhanced MRI (CE-MRI), 8 of 10 cases showed intensely ring-enhanced tumor with necrotic lesion. Histopathologically, 7 of 8 cases whose tumor had been resected before treatment had necrosis with increased vascularity or bleeding. Of the remaining 2 cases one case, malignant lymphoma had only hypervascularity by biopsy, while the other one was excluded for resection after treatment. Three of these 8 cases whose CE-CT or CE-MRI showed necrotic lesions exhibited Tc and Tl accumulations in the area corresponding to necrosis. In contrast, 2 showed no Tc nor Tl uptake. Tc-T/N had no significant correlation with any of early-, delayed-T/N or T/S. In conclusion, there was no significant correlation between Tc and Tl uptakes by malignant brain tumors in semi-quantitative evaluation.

Original languageEnglish
Pages (from-to)387-392
Number of pages6
JournalAnnals of Nuclear Medicine
Volume17
Issue number5
Publication statusPublished - 2003 Jul
Externally publishedYes

Fingerprint

Single-Photon Emission-Computed Tomography
Brain Neoplasms
Bone and Bones
Necrosis
Neoplasms
Technetium Tc 99m Medronate
Scalp
Skull
Chlorides
Lymphoma
Differential Diagnosis
Hemorrhage
Calcium
Biopsy
Recurrence
Brain

Keywords

  • Tl
  • Tc-(H)MDP
  • Extraosseous accumulation
  • Malignant brain tumor
  • Semi-quantitative evaluation

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging

Cite this

Extraosseous accumulation of bone scanning agents in malignant brain tumors : Comparison to semi-quantitative evaluation with 99mTc SPECT/201Tl SPECT and histological findings. / Suzuki, Aya; Togawa, Takashi; Kuyama, Junpei; Nakahara, Tadaki; Iuchi, Toshihiko; Oga, Masaru; Osato, Katsunobu; Takenouchi, Toshinao.

In: Annals of Nuclear Medicine, Vol. 17, No. 5, 07.2003, p. 387-392.

Research output: Contribution to journalArticle

Suzuki, Aya ; Togawa, Takashi ; Kuyama, Junpei ; Nakahara, Tadaki ; Iuchi, Toshihiko ; Oga, Masaru ; Osato, Katsunobu ; Takenouchi, Toshinao. / Extraosseous accumulation of bone scanning agents in malignant brain tumors : Comparison to semi-quantitative evaluation with 99mTc SPECT/201Tl SPECT and histological findings. In: Annals of Nuclear Medicine. 2003 ; Vol. 17, No. 5. pp. 387-392.
@article{3f1d4626158a47de840743e212a8aaec,
title = "Extraosseous accumulation of bone scanning agents in malignant brain tumors: Comparison to semi-quantitative evaluation with 99mTc SPECT/201Tl SPECT and histological findings",
abstract = "Although 201Tl chloride (Tl) SPECT has been used in the differential diagnosis between recurrence of malignant brain tumor and necrosis after treatment, it is not generally recognized as a definite modality to distinguish them. We conducted a preliminary study using Tl SPECT and 99mTc-MDP or 99mTc-HMDP (Tc) SPECT because it has been said that extraosseous accumulation was caused by calcium deposits in necrotic tissues. In our study, for the purposes of clarifying the mechanism of extraosseous uptake and the correlation between extraosseous accumulation of bone-scanning agent and tumor viability in malignant brain tumors, we compared whether Tc uptake was correlated with the histopathological findings and further performed semi-quantitative evaluation between Tc SPECT and Tl SPECT. The correlation coefficients between the ratio of tumor to normal skull count obtained from Tc SPECT (Tc-T/N) and those of tumor to normal brain count (T/N) and to normal scalp count (T/S) both obtained from Tl SPECT were calculated. Using contrast enhanced CT (CE-CT) or contrast enhanced MRI (CE-MRI), 8 of 10 cases showed intensely ring-enhanced tumor with necrotic lesion. Histopathologically, 7 of 8 cases whose tumor had been resected before treatment had necrosis with increased vascularity or bleeding. Of the remaining 2 cases one case, malignant lymphoma had only hypervascularity by biopsy, while the other one was excluded for resection after treatment. Three of these 8 cases whose CE-CT or CE-MRI showed necrotic lesions exhibited Tc and Tl accumulations in the area corresponding to necrosis. In contrast, 2 showed no Tc nor Tl uptake. Tc-T/N had no significant correlation with any of early-, delayed-T/N or T/S. In conclusion, there was no significant correlation between Tc and Tl uptakes by malignant brain tumors in semi-quantitative evaluation.",
keywords = "Tl, Tc-(H)MDP, Extraosseous accumulation, Malignant brain tumor, Semi-quantitative evaluation",
author = "Aya Suzuki and Takashi Togawa and Junpei Kuyama and Tadaki Nakahara and Toshihiko Iuchi and Masaru Oga and Katsunobu Osato and Toshinao Takenouchi",
year = "2003",
month = "7",
language = "English",
volume = "17",
pages = "387--392",
journal = "Annals of Nuclear Medicine",
issn = "0914-7187",
publisher = "Springer Japan",
number = "5",

}

TY - JOUR

T1 - Extraosseous accumulation of bone scanning agents in malignant brain tumors

T2 - Comparison to semi-quantitative evaluation with 99mTc SPECT/201Tl SPECT and histological findings

AU - Suzuki, Aya

AU - Togawa, Takashi

AU - Kuyama, Junpei

AU - Nakahara, Tadaki

AU - Iuchi, Toshihiko

AU - Oga, Masaru

AU - Osato, Katsunobu

AU - Takenouchi, Toshinao

PY - 2003/7

Y1 - 2003/7

N2 - Although 201Tl chloride (Tl) SPECT has been used in the differential diagnosis between recurrence of malignant brain tumor and necrosis after treatment, it is not generally recognized as a definite modality to distinguish them. We conducted a preliminary study using Tl SPECT and 99mTc-MDP or 99mTc-HMDP (Tc) SPECT because it has been said that extraosseous accumulation was caused by calcium deposits in necrotic tissues. In our study, for the purposes of clarifying the mechanism of extraosseous uptake and the correlation between extraosseous accumulation of bone-scanning agent and tumor viability in malignant brain tumors, we compared whether Tc uptake was correlated with the histopathological findings and further performed semi-quantitative evaluation between Tc SPECT and Tl SPECT. The correlation coefficients between the ratio of tumor to normal skull count obtained from Tc SPECT (Tc-T/N) and those of tumor to normal brain count (T/N) and to normal scalp count (T/S) both obtained from Tl SPECT were calculated. Using contrast enhanced CT (CE-CT) or contrast enhanced MRI (CE-MRI), 8 of 10 cases showed intensely ring-enhanced tumor with necrotic lesion. Histopathologically, 7 of 8 cases whose tumor had been resected before treatment had necrosis with increased vascularity or bleeding. Of the remaining 2 cases one case, malignant lymphoma had only hypervascularity by biopsy, while the other one was excluded for resection after treatment. Three of these 8 cases whose CE-CT or CE-MRI showed necrotic lesions exhibited Tc and Tl accumulations in the area corresponding to necrosis. In contrast, 2 showed no Tc nor Tl uptake. Tc-T/N had no significant correlation with any of early-, delayed-T/N or T/S. In conclusion, there was no significant correlation between Tc and Tl uptakes by malignant brain tumors in semi-quantitative evaluation.

AB - Although 201Tl chloride (Tl) SPECT has been used in the differential diagnosis between recurrence of malignant brain tumor and necrosis after treatment, it is not generally recognized as a definite modality to distinguish them. We conducted a preliminary study using Tl SPECT and 99mTc-MDP or 99mTc-HMDP (Tc) SPECT because it has been said that extraosseous accumulation was caused by calcium deposits in necrotic tissues. In our study, for the purposes of clarifying the mechanism of extraosseous uptake and the correlation between extraosseous accumulation of bone-scanning agent and tumor viability in malignant brain tumors, we compared whether Tc uptake was correlated with the histopathological findings and further performed semi-quantitative evaluation between Tc SPECT and Tl SPECT. The correlation coefficients between the ratio of tumor to normal skull count obtained from Tc SPECT (Tc-T/N) and those of tumor to normal brain count (T/N) and to normal scalp count (T/S) both obtained from Tl SPECT were calculated. Using contrast enhanced CT (CE-CT) or contrast enhanced MRI (CE-MRI), 8 of 10 cases showed intensely ring-enhanced tumor with necrotic lesion. Histopathologically, 7 of 8 cases whose tumor had been resected before treatment had necrosis with increased vascularity or bleeding. Of the remaining 2 cases one case, malignant lymphoma had only hypervascularity by biopsy, while the other one was excluded for resection after treatment. Three of these 8 cases whose CE-CT or CE-MRI showed necrotic lesions exhibited Tc and Tl accumulations in the area corresponding to necrosis. In contrast, 2 showed no Tc nor Tl uptake. Tc-T/N had no significant correlation with any of early-, delayed-T/N or T/S. In conclusion, there was no significant correlation between Tc and Tl uptakes by malignant brain tumors in semi-quantitative evaluation.

KW - Tl

KW - Tc-(H)MDP

KW - Extraosseous accumulation

KW - Malignant brain tumor

KW - Semi-quantitative evaluation

UR - http://www.scopus.com/inward/record.url?scp=0042319226&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0042319226&partnerID=8YFLogxK

M3 - Article

VL - 17

SP - 387

EP - 392

JO - Annals of Nuclear Medicine

JF - Annals of Nuclear Medicine

SN - 0914-7187

IS - 5

ER -