Value of Thallium-201 SPECT and SPECT/CT Brain Imaging in Differentiating Malignant from Nonmalignant Lesions: A Comparative Case-Series Study with Pathologic and/or Clinical Correlation
Nicole Girlyn T. Pang1, Lara Triccia Luistro2, Christianne Mojica1, Allan Jay Domingo2, Julette Batara1
1Neurology, St Luke's Medical Center, 2Nuclear Medicine, St Luke's Medical Center Global City
Objective:
To describe results of patients who underwent Thallium-201 Single-photon Emission Computed Tomography and Computed Tomography (SPECT/CT) Brain Imaging and relate it to clinical and/or histopathologic findings. This is the first study in the Philippines that documented the correlation between Thallium-201 SPECT/CT findings with histologic and/or clinical diagnosis.
Background:
Thallium-201 SPECT/CT brain scanning is an imaging modality which can be done to differentiate between malignant and non-malignant lesions. Despite its availability, the procedure has been under-utilized and the lack of knowledge about its potential use can be the significant barrier in maximizing its clinical utility.
Design/Methods:
This is a retrospective case series study of 10 patients with cerebral lesions who underwent Thallium-201 SPECT/CT brain imaging in a hospital in the Philippines from 2010 to 2021.
Results:
From 2010 to 2021, a total of 10 patients underwent Thallium-201 SPECT/CT brain scan. Six had negative results while 4 had positive results. All of the patients who had positive results were found to have malignancy, whether recurrent or newly diagnosed. All of the patients with negative scan were found to have either an infectious and inflammatory disease and responded to treatment albeit in different degrees. Two of the 10 patients underwent biopsy whose results were consistent with the Thallium-201 SPECT/CT brain scan results.
Conclusions:
The findings in this study support the role of thallium scintigraphy in the diagnosis of patients with brain lesions most significantly when there is a need to differentiate between a malignant and benign condition. Thallium scintigraphy is a more affordable option compared to Magnetic Resonance Imaging whether conventional or combined with spectroscopy or perfusion studies. In the Philippine setting where cost can be an important factor in the choice of diagnostic procedure, this study further supports the use of Thallium-201 SPECT/CT scan in the diagnosis of patients with brain lesions.