Abstract
Objective: To establish the value of thallium-201 single-photon emission computed tomography (201Tl-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 (201Tl 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, 201Tl 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 201Tl index > 1.9 and a MIB-1 index > 6% were associated with short PFS. Conclusion: 201Tl 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 201Tl uptake, even if the tumor demonstrates low proliferative activity on histopathologic examination.
| Original language | English |
|---|---|
| Pages (from-to) | 223-229 |
| Number of pages | 7 |
| Journal | Clinical Neurology and Neurosurgery |
| Volume | 114 |
| Issue number | 3 |
| DOIs | |
| Publication status | Published - 2012 Apr 1 |
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Keywords
- Biopsy
- Low-grade astrocytoma
- Progression-free survival
- Single-photon emission computed tomography
ASJC Scopus subject areas
- Clinical Neurology
- Surgery
Cite this
Usefulness of thallium-201 SPECT for prediction of early progression in low-grade astrocytomas diagnosed by stereotactic biopsy. / Park, Kyung-Jae; Kang, Shin-Hyuk; Park, Dong-Hyuk; Cho, Tai Hyoung; Choe, Jae-Gol; Chung, Yong Gu.
In: Clinical Neurology and Neurosurgery, Vol. 114, No. 3, 01.04.2012, p. 223-229.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Usefulness of thallium-201 SPECT for prediction of early progression in low-grade astrocytomas diagnosed by stereotactic biopsy
AU - Park, Kyung-Jae
AU - Kang, Shin-Hyuk
AU - Park, Dong-Hyuk
AU - Cho, Tai Hyoung
AU - Choe, Jae-Gol
AU - Chung, Yong Gu
PY - 2012/4/1
Y1 - 2012/4/1
N2 - Objective: To establish the value of thallium-201 single-photon emission computed tomography (201Tl-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 (201Tl 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, 201Tl 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 201Tl index > 1.9 and a MIB-1 index > 6% were associated with short PFS. Conclusion: 201Tl 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 201Tl uptake, even if the tumor demonstrates low proliferative activity on histopathologic examination.
AB - Objective: To establish the value of thallium-201 single-photon emission computed tomography (201Tl-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 (201Tl 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, 201Tl 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 201Tl index > 1.9 and a MIB-1 index > 6% were associated with short PFS. Conclusion: 201Tl 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 201Tl uptake, even if the tumor demonstrates low proliferative activity on histopathologic examination.
KW - Biopsy
KW - Low-grade astrocytoma
KW - Progression-free survival
KW - Single-photon emission computed tomography
UR - http://www.scopus.com/inward/record.url?scp=84857785576&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84857785576&partnerID=8YFLogxK
U2 - 10.1016/j.clineuro.2011.10.023
DO - 10.1016/j.clineuro.2011.10.023
M3 - Article
C2 - 22104697
AN - SCOPUS:84857785576
VL - 114
SP - 223
EP - 229
JO - Clinical Neurology and Neurosurgery
JF - Clinical Neurology and Neurosurgery
SN - 0303-8467
IS - 3
ER -