scholarly journals Usefulness of Dual Isotope 123I-IMP and 201Tl SPECT for the Diagnosis of Primary Central Nervous System Lymphoma and Glioblastoma

2021 ◽  
Author(s):  
Sho Osawa ◽  
Masahiko Tosaka ◽  
Keishi Horiguchi ◽  
Azusa Tokue ◽  
Tetsuya Higuchi ◽  
...  
Keyword(s):  
Central Nervous System ◽  
Nervous System ◽  
Single Photon ◽  
Photon Emission ◽  
Area Under The Curve ◽  
Central Nervous System Lymphoma ◽  
Emission Computed Tomography ◽  
Dual Isotope ◽  
Apparent Diffusion Coefficient Values ◽  
The Mean

Abstract IntroductionPreoperative differential diagnosis between glioblastoma (GBM) and primary central nervous system lymphoma (PCNSL) is important because these tumors require different surgical strategies. This study investigated the usefulness of dual isotope, iodine-123-labeled N-isopropyl-p-iodoamphetamine (123I-IMP) and thallium-201 chloride single photon emission computed tomography (201Tl SPECT) for the differential diagnosis.MethodsTwenty-five PCNSL patients and 27 GBM patients who underwent dual isotope, 123I-IMP and 201Tl SPECT are included. Tumor to normal (T/N) ratio was calculated from the ratio of maximum tracer counts in the contrast-enhanced lesion to the mean counts in the contralateral cerebral cortex. The mean and minimum apparent diffusion coefficient values (ADCmean, and ADCmin, respectively) on magnetic resonance imaging were also analyzed. ResultsTumor to normal (T/N) ratios of PCNSL were significantly higher than that of GBM for both isotopes and phases (P < 0.001). Both ADC values of PCNSL were significantly lower than those of GBM (P < 0.001). Delayed phase 123I-IMP gave the most accurate findings for differentiation between PCNSL and GBM with the optimum cut-off value of 1.009, sensitivity 92.0%, specificity 88.9%, and area under the curve 0.945 (95% confidence interval, 0.883-1.000). Fifty of 52 patients (96.2%) showed retention index of 201Tl SPECT 0.7 or higher, which indicates malignant brain tumors. ConclusionsDelayed phase 123I-IMP SPECT could differentiate between PCNSL and GBM with the highest accuracy. 201Tl SPECT was useful for estimation of the malignancy and localization of the tumors. Dual isotope 123I-IMP and 201Tl SPECT was useful for the preoperative diagnosis of PCNSL and GBM.

scholarly journals Case report of an elderly woman with atypical imaging for primary central nervous system lymphoma who needed a brain biopsy for diagnosis

2021 ◽  
Vol 49 (8) ◽  
pp. 030006052110351
Author(s):  
Kosuke Matsuzono ◽  
Tomoya Yagisawa ◽  
Keisuke Ohtani ◽  
Yohei Ishishita ◽  
Takashi Yamaguchi ◽  
...  
Keyword(s):  
Central Nervous System ◽  
Nervous System ◽  
Fdg Pet ◽  
Single Photon ◽  
Photon Emission ◽  
Central Nervous System Lymphoma ◽  
Brain Biopsy ◽  
Emission Computed Tomography ◽  
Stereotactic Brain Biopsy ◽  
Imaging Results

Primary central nervous system lymphoma (PCNSL) is a rare form of non-Hodgkin lymphoma, but its diagnosis is challenging in some cases. A brain biopsy is the gold standard for diagnosing PCNSL, but its invasiveness can be problematic. Thus, noninvasive imaging examinations have been developed for the pre-surgical diagnosis of PCNSL, including gadolinium-enhanced magnetic resonance imaging (MRI), 123I-N-isopropyl-p-iodoamphetamine single-photon emission computed tomography (123I-IMP SPECT), and positron emission tomography with 18F-fluorodeoxyglucose (18F-FDG PET). Here, we report the case of a 71-year-old woman with negative imaging findings for PCNSL, but who was diagnosed with PCNSL by a brain biopsy and histological analysis. Her imaging results were negative for gadolinium-enhanced cranial MRI, with low uptake in 123I-IMP SPECT and hypometabolism in 18F-FDG PET. However, a stereotactic brain biopsy from an abnormal lesion revealed that many round cells had infiltrated into the brain. Moreover, many infiltrating cells were positive for cluster of differentiation (CD)20 and CD79a, and proliferation marker protein Ki-67-positive cells accounted for nearly 80% of all cells. Based on these results, our final pathological diagnosis was PCNSL. The present case highlights the possibility of a PCNSL diagnosis even when all imaging-related examinations display negative results.

Glioblastoma and primary central nervous system lymphoma: differentiation using MRI derived first-order texture analysis – a machine learning study

2021 ◽  
pp. 197140092199897
Author(s):  
Sarv Priya ◽  
Caitlin Ward ◽  
Thomas Locke ◽  
Neetu Soni ◽  
Ravishankar Pillenahalli Maheshwarappa ◽  
...  
Keyword(s):  
Machine Learning ◽  
Central Nervous System ◽  
Nervous System ◽  
Diagnostic Performance ◽  
Model Performance ◽  
Area Under The Curve ◽  
Central Nervous System Lymphoma ◽  
First Order ◽  
Single Slice ◽  
Contrast Enhanced

Objectives To evaluate the diagnostic performance of multiple machine learning classifier models derived from first-order histogram texture parameters extracted from T1-weighted contrast-enhanced images in differentiating glioblastoma and primary central nervous system lymphoma. Methods Retrospective study with 97 glioblastoma and 46 primary central nervous system lymphoma patients. Thirty-six different combinations of classifier models and feature selection techniques were evaluated. Five-fold nested cross-validation was performed. Model performance was assessed for whole tumour and largest single slice using receiver operating characteristic curve. Results The cross-validated model performance was relatively similar for the top performing models for both whole tumour and largest single slice (area under the curve 0.909–0.924). However, there was a considerable difference between the worst performing model (logistic regression with full feature set, area under the curve 0.737) and the highest performing model for whole tumour (least absolute shrinkage and selection operator model with correlation filter, area under the curve 0.924). For single slice, the multilayer perceptron model with correlation filter had the highest performance (area under the curve 0.914). No significant difference was seen between the diagnostic performance of the top performing model for both whole tumour and largest single slice. Conclusions T1 contrast-enhanced derived first-order texture analysis can differentiate between glioblastoma and primary central nervous system lymphoma with good diagnostic performance. The machine learning performance can vary significantly depending on the model and feature selection methods. Largest single slice and whole tumour analysis show comparable diagnostic performance.

scholarly journals Lateral intraventricular primary central nervous system lymphoma (LIPCNSL): a review

QJM ◽  
2020 ◽  
Vol 113 (7) ◽  
pp. 457-464
Author(s):  
J Yang ◽  
Z Liu ◽  
Y Yang ◽  
H Chen ◽  
J Xu
Keyword(s):  
Central Nervous System ◽  
Nervous System ◽  
Central Nervous System Lymphoma ◽  
Salvage Treatment ◽  
High Dose ◽  
High Dose Methotrexate ◽  
Limb Weakness ◽  
Dose Methotrexate ◽  
Maximal Diameter ◽  
The Mean

Abstract Background Lateral intraventricular primary central nervous system lymphoma (LIPCNSL) is an extremely rare intraventricular tumor with high malignancy and has never been systematically described. Aim To analyze the clinical characteristics and therapeutic strategy of LIPCNSL. Design Single-center retrospective study. Methods The clinical manifestation, imaging, treatment and outcomes of 13 patients with LIPCNSL who underwent craniotomy in West China Hospital between December 2008 and April 2018 were retrospectively analyzed. Results Eleven male and two female patients were enrolled. The mean age was 49.7 years (14–65 years). The frequent manifestations include symptoms of raised intracranial pressure and limb weakness. The mean duration was 1.8 months (1 week to 1 year). The average maximal diameter of tumors was 4.1 cm (1.8–6.1 cm). Gross total resection was achieved in 84.6% of patients. Symptoms improved in 69.2% of patients but developed in 30.8% of patients after surgery. The median recurrence-free survival (RFS) and overall survival (OS) were 2.0 months (1–86 months) and 3.0 months (1–124 months). High-dose methotrexate or/and radiotherapy significantly prolonged the RFS and OS (P &lt; 0.05). Eight patients (72.7%) experienced relapse and progression. Salvage treatment significantly prolonged survival after relapse (P &lt; 0.05). Conclusions LIPCNSL should be considered as a differential diagnosis of intraventricular tumors. High-dose methotrexate-based chemotherapy with or without radiotherapy should be the first-line treatment, and surgery is only for biopsy and improving symptoms. Long-term intensive follow-up is necessary and active salvage treatment should be performed after relapse.

Abstract 170: Inflammation Imaging in the Primate Heart Using 111 In-Labeled Anti-Tenascin-C Antibody

2012 ◽  
Vol 111 (suppl_1) ◽  
Author(s):  
Michiaki Hiroe ◽  
Naohide Ageyama ◽  
Yasuhiro Yasutomi ◽  
Hiroyuki Kurosawa ◽  
Ousuke Fujimoto ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Single Photon ◽  
Photon Emission ◽  
Border Zone ◽  
Myocardial Inflammation ◽  
Emission Computed Tomography ◽  
Myocardial Uptake ◽  
Dual Isotope ◽  
Tenascin C ◽  
Active Inflammation

Myocardial inflammation after myocardial infarction and myocarditis may cause cardiac remodeling, leading to congestive heart failure and arrhythmias. Tenascin-C (TNC), an extracellular matrix glycoprotein, is not normally expressed but specifically expressed associated with active inflammation. The aim of this study was to explore the myocardial expression of TNC after myocardial infarction in Macaca fascicularis (crab-eating monkey) using 111 In-labeled anti-TNC antibody ( 111 In-TNC-Fab’). The left coronary artery was permanently ligated in two monkies and 4 days later, we performed dual-isotope single-photon emission computed tomography imaging (SPECT) of 111 In-TNC-Fab’ and 99m Tc methoxy- isobutyl isonitrile (MIBI), and compared with those of an age-matched control. Then, dual autoradiography was compared with histology and immunostaining for TNC of the heart. Dual-isotope SPECT demonstrated the regional myocardial uptake of 111 In-TNC-Fab’ in the areas of decreased uptake of MIBI. On autoradiography, the radioactivities were observed in the border zone between the infarcted and the noninfarcted area of MI hearts. The hot spots corresponded with the positively immunostained areas. In contrast, no radioactivites of 111 In-TNC-Fab’ were detected in the control. These data clearly indicated that, using 111 In-TNC-Fab’, we can visualize the inflammatory lesions followed by myocardial infarction of the primate.

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