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Usefulness of thallium-201 SPECT for prediction of early progression in low-grade astrocytomas diagnosed by stereotactic biopsy

Authors
Park, Kyung-JaeKang, Shin-HyukPark, Dong-HyukCho, Tai-HyoungChoe, Jae GolChung, Yong-Gu
Issue Date
4월-2012
Publisher
ELSEVIER SCIENCE BV
Keywords
Biopsy; Low-grade astrocytoma; Progression-free survival; Single-photon emission computed tomography
Citation
CLINICAL NEUROLOGY AND NEUROSURGERY, v.114, no.3, pp.223 - 229
Indexed
SCIE
SCOPUS
Journal Title
CLINICAL NEUROLOGY AND NEUROSURGERY
Volume
114
Number
3
Start Page
223
End Page
229
URI
https://scholar.korea.ac.kr/handle/2021.sw.korea/133865
DOI
10.1016/j.clineuro.2011.10.023
ISSN
0303-8467
Abstract
Objective: To establish the value of thallium-201 single-photon emission computed tomography (Tl-201-SPECT) as a predictor of early progression in low-grade astrocytomas (LGAs). Methods: We studied 57 consecutive patients who underwent 201 Tl-SPECT before stereotactic biopsy (n = 33) or surgical resection (n = 24). The value of radiologic and histopathological variables (Tl-201 index and MIB-1 index) in predicting progression free survival (PFS) was examined in each group of patients. Results: During a median follow up of 55 months (range, 11-101), progression of the primary lesion was identified in 46 patients (80.7%). Based on Cox's proportional hazards model, the increased thallium uptake was associated with a short PFS in both biopsy and resection groups, whereas the MIB-1 index was significant only in the resection group. Considering the cut-off value, Tl-201 index > 1.7 was statistically significant for reduced PFS in the biopsy group; however, MIB-1 index was not directly related to the PFS at any level. For the surgical resection group, both a Tl-201 index > 1.9 and a MIB-1 index > 6% were associated with short PFS. Conclusion: Tl-201 SPECT may play a role in prediction of early tumor progression not only in resected LGAs, but also in biopsy-proven LGAs. Therefore, we suggest that patients with LGAs established from biopsy should be considered as high-risk groups for early progression if the tumor shows a high Tl-201 uptake, even if the tumor demonstrates low proliferative activity on histopathologic examination. (C) 2011 Elsevier B.V. All rights reserved.
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