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
N1 - Funding Information:
This study was supported by grants from the Korea Research Foundation ( 2010-0009959 ) and the center for clinical trials of Korea University Anam Hospital.
PY - 2012/4
Y1 - 2012/4
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
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 -