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123I-IMT
SPECT and 1HMR-Spectroscopy at 3.0T in the Differential Diagnosis of
Recurrent or Residual Gliomas: A Comparative Study
Michail Plotkin, Julia Eisenacher, Harald
Bruhn, Reinhard Wurm, Roger Michel, Florian Stockhammer, Annelie
Feußner,
Oliver Dudeck, Peter Wust, Roland Felix, Holger Amthauer
Klink
für
Strahlenheilkunde, Universitätsklinik Charité, Campus Virchow-Klinikum, Augustenburger Platz 1, 13353
Berlin, Germany; Tel.: +49-030-450-557-127; Fax: +49-030-450-557-901; E-mail: michail.plotkin@charite.de
[M.P.]. Klinik für
Strahlenheilkunde, Campus Virchow-Klinikum [J.E.,
H.B., R.M., A.F., O.D., P.W., R.F., H. A.]. Klinik für
Strahlentherapie, Campus Mitte [R.W.].
Klinik für
Neurochirurgie, Campus Virchow-Klinikum, Charité Universitätsmedizin, Berlin, Germany [F.S.].
The aim
of this investigation was to compare two current non-invasive modalities, single
photon emission tomography (SPECT) using 123-iodine-α-methyl
tyrosine (123I-IMT) and single-voxel proton magnetic resonance
spectroscopy (1H-MRS) at 3.0 T, with regard to their ability to
differentiate between residual/recurrent tumors and treatment-related changes in
patients pretreated for glioma.
The patient population comprised 25 patients in whom recurrent glioma was
suspected based on MR imaging.
SPECT imaging started 10 min after iv. injection of 300–370
MBq 123I-IMT and was performed using a triple-head system.
The IMT uptake was
calculated semiquantitatively using regions-of-interest.
1H-MRS was
performed at 3.0 T using the single-volume point-resolved spectroscopy (PRESS)
technique.
Guided by MR imaging
volumes-of-interest for spectroscopy were placed into the suspected
lesions.
Signal intensities of
choline-containing compounds (Cho), creatine and phosphocreatine (Cr), and
N-acetylaspartate (NAA) were obtained.
When using the cut-off
of 1.62 for 123I-IMT uptake, the sensitivity, specificity, and
accuracy of the 123I-IMT SPECT were 95, 100 and 96%,
respectively.
For 1H-MRS,
the sensitivity, specificity and accuracy were 89, 83 and 88%, respectively,
based both on the metabolic ratios of Cho/Cr and Cho/NAA as tumor criterion with
cut-off values of 1.11 and 1.17, respectively.
In conclusion, 123I-IMT
SPECT yielded more favorable results compared to 1H-MRS at
distinguishing recurrent and/or residual glioma from post-therapeutic changes
and may be particularly valuable when the evaluation of tumor extent is
necessary.
Keywords:
3-[123I]iodine-α-methyl-L-tyrosine,
proton magnetic resonance spectroscopy, recurrent glioma, single photon emission
tomography, 3.0 T
Copyright
©
2004 Kluwer Academic Publishers.
All rights reserved
Source: http://ipsapp009.kluweronline.com/IPS/content/ext/x/J/5042/I/123/A/2/abstract.htm
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