Skip to main content
SpringerLink
Log in

Extraosseous accumulation of bone scanning agents in malignant brain tumors: Comparison to semi-quantitative evaluation with99mTc SPECT/201Tl SPECT and histological findings

  • Original Articles
  • Published:
Annals of Nuclear Medicine Aims and scope Submit manuscript

Abstract

Although201Tl chloride (Tl) SPECT has been used in the differential diagnosis between recurrence of malignant brain tumor and necrosis after treatment, it is not generally recognized as a definite modality to distinguish them. We conducted a preliminary study using Tl SPECT and99mTc-MDP or99mTc-HMDP (Tc) SPECT because it has been said that extraosseous accumulation was caused by calcium deposits in necrotic tissues. In our study, for the purposes of clarifying the mechanism of extraosseous uptake and the correlation between extraosseous accumulation of bone-scanning agent and tumor viability in malignant brain tumors, we compared whether Tc uptake was correlated with the histopathological findings and further performed semi-quantitative evaluation between Tc SPECT and Tl SPECT. The correlation coefficients between the ratio of tumor to normal skull count obtained from Tc SPECT (Tc-T/N) and those of tumor to normal brain count (T/N) and to normal scalp count (T/S) both obtained from Tl SPECT were calculated. Using contrast enhanced CT (CECT) or contrast enhanced MRI (CE-MRI), 8 of 10 cases showed intensely ring-enhanced tumor with necrotic lesion. Histopathologically, 7 of 8 cases whose tumor had been resected before treatment had necrosis with increased vascularity or bleeding. Of the remaining 2 cases one case, malignant lymphoma had only hypervascularity by biopsy, while the other one was excluded for resection after treatment. Three of these 8 cases whose CE-CT or CE-MRI showed necrotic lesions exhibited Tc and Tl accumulations in the area corresponding to necrosis. In contrast, 2 showed no Tc nor Tl uptake. Tc-T/N had no significant correlation with any of early-, delayed-T/N or T/S. In conclusion, there was no significant correlation between Tc and Tl uptakes by malignant brain tumors in semiquantitative evaluation.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Yasuda E, Yoshida H, Ichikawa H, Matsuo S, Kimura T, Kanamori I, et al. Extraosseous accumulation of99mTc-MDP — with special reference to intratumor accumulation.Rinsho Hoshasen 1983; 28: 851–857. (in Japanese)

    PubMed  CAS  Google Scholar 

  2. Sty JR, Starshak RJ, Casper JT. Extraosseous accumulation of99mTc-MDP. Metastatic intracranial neuroblastoma.Clin Nucl Med 1983; 8: 26–27.

    Article  PubMed  CAS  Google Scholar 

  3. Ozarda AT, Legaspi JR, Haynie TP. Detection of a brain metastasis from osteosarcoma with99mTc-methylene diphosphonate bone scanning.Eur J Nucl Med 1983; 8: 552–554.

    PubMed  CAS  Google Scholar 

  4. Grames GM, Jansen C, Carlsen EN, Davidson TR. The abnormal bone scan in intracranial lesions.Radiology 1975; 115: 129–134.

    PubMed  CAS  Google Scholar 

  5. Chaudhuri TK, Chaudhuri TK, Gulesserian HP, Christie JH, Tonami N. Extraosseous noncalcified soft-tissue uptake of99mTc-polyphosphate.J Nucl Med 1974; 15: 1054–1056.

    PubMed  CAS  Google Scholar 

  6. Suzuki A, Togawa T, Kuyama J, Nakahara T, Yui N, Iuchi T, et al. Extraosseous accumulation of99mTc phosphonate complexes in primary brain tumor evaluated with SPECT.Ann Nucl Med 2002; 16: 495–498.

    Article  PubMed  Google Scholar 

  7. Shiomi S, Kuroki T, Hasegawa I, Nishio H, Azuma K, Ochi H. Accumulation of99mTc-HMDP in hepatic metastasis from colon carcinoma without detectable calcification.Ann Nucl Med 1996; 10: 347–349.

    Article  PubMed  CAS  Google Scholar 

  8. Rengachary SS, Batnitzky S, Arjunan K. Diagnosis of intracranial meningioma with radionuclide bone scan.Surg Neurol 1980; 14: 337–341.

    PubMed  CAS  Google Scholar 

  9. Buja LM, Tofe AJ, Kulkarni PV, Mukherjee A, Parke RW, Franci MD, et al. Sites and mechanisms of localization of technetium-99m phosphorus radiopharmaceuticals in acute myocardial infarcts and other tissues.J Clin Invest 1977; 60: 724–740.

    Article  PubMed  CAS  Google Scholar 

  10. Yoshida S, Fukumoto M, Yoshimura N, Oobayashi K, Takada Y. Ectopic accumulation of99mTc-HMDP in primary lung cancer in comparison with CT findings.Ann Nucl Med 1996; 10: 329–333.

    Article  PubMed  CAS  Google Scholar 

  11. Togawa T, Hoshi K, Kimura K, Sato T, Matsuda S, Uchida T, et al. A case of adult T-cell leukemia with metastatic calcification.Eur J Nucl Med 1985; 10: 90–92.

    Article  PubMed  CAS  Google Scholar 

  12. Rosenthall L.99mTc-methylene diphosphonate concentration in soft tissue malignant fibrous histiocytoma.Clin Nucl Med 1978; 3: 58–61.

    Article  PubMed  CAS  Google Scholar 

  13. Parkey RW, Bonte FJ, Meyer SL, Atkins JM, Curry GL, Stokely EM, et al. A new method for radionuclide imaging of acute myocardial infarction in humans.Circulation 1974; 50: 540–546.

    PubMed  CAS  Google Scholar 

  14. Corbett JR, Lewis M, Willerson JT, Nicod PH, Huxley RL, Simon T, et al.99mTc-pyrophosphate imaging in patients with acute myocardial infarction: comparison of planar imaging with single-photon tomography with and without blood pool overlay.Circulation 1984; 69: 1120–1128.

    PubMed  CAS  Google Scholar 

  15. Fujiwara Y, Itoh T, Douiuchi J, Ochi T, Kokubu T, Murase K, et al. Quantitative analysis of acute myocardial infarction using single photon emission computed tomography using technetium-99m pyrophosphate.J Cardiogr 1986; 16: 555–562.

    PubMed  CAS  Google Scholar 

  16. Krause T, Hohnloser SH, Kasper W, Schumichen C, Reinhardt M, Moser E. Assessment of acute myocardial necrosis after cardiopulmonary resuscitation and cardioversion by means of combined thallium-201/technetium-99m pyrophosphate tomography.Eur J Nucl Med 1995; 22: 1286–1291.

    Article  PubMed  CAS  Google Scholar 

  17. Kawano M, Taki J, Kinuya S, Higuchi T, Nakajima K, Miyazaki Y, et al. Improvement of99mTc-pyrophosphate scintigraphy in detection of acute myocardial infarction: combined with99mTc-tetrofosmin.KAKU IGAKU (Jpn J Nucl Med) 2001; 38: 707–713. (in Japanese)

    CAS  Google Scholar 

  18. Dewanjee MK, Kahn PC. Mechanism of localization of99mTc-labeled pyrophosphate and tetracycline in infarcted myocardium.J Nucl Med 1976; 17: 639–646.

    PubMed  CAS  Google Scholar 

  19. Slizofski WJ, Krishna L, Kasetos CD, Black P, Miyamoto C, Brown SJ, et al. Thallium imaging for brain tumors with results measured by semiquantitative index and correlated with histopathology.Cancer 1994; 74: 3190–3197.

    Article  PubMed  CAS  Google Scholar 

  20. Igase K, Oka Y, Ohta S, Murakami Y, Kumo Y, Sasaki S. Usefulness of thallium-201 single photon emission computed tomography to quantify the malignancy grade of brain tumors.Neurol Med Clir (Tokyo) 1996; 36: 434–439.

    Article  CAS  Google Scholar 

  21. Kallen K, Heiling M, Andersson AM, Brun A, Holtas S, Ryding E, et al. Evaluation of malignancy in ring enhancing brain lesions on CT by thallium-201 SPECT.J Neurol Neurosurg Psychiatry 1997; 63: 569–574.

    Article  PubMed  CAS  Google Scholar 

  22. Higa T, Maetani S, Kobayashi Y, Nabeshima S.201Tl SPECT compared with histopathologic grade in the prognostic assessment of cerebral gliomas.Clin Nucl Med 2001; 26: 119–124.

    Article  PubMed  CAS  Google Scholar 

  23. Kosuda S, Shinoyama Y, Kamata N, Suzuki K, Tanaka Y, Nakamura O, et al. Differential diagnosis between recurrence of brain tumor and radiation necrosis by201Tl SPECT.Nippon Igaku Hoshasen Gakkai Zasshi 1991; 51 (4): 415–421. (in Japanese)

    PubMed  CAS  Google Scholar 

  24. Serizawa T, Ono J, Odaki M, Hirai S, Sato M, matsuda S, et al. Differentiation between tumor recurrence and radiation injury after gamma knife radiosurgery for metastatic brain tumors: value of serial thallium-201 chloride SPECT.Jpn J Neurosurg (Tokyo) 2001; 10: 726–732. (in Japanese)

    Google Scholar 

  25. Yoshii Y, Satou M, Yamamoto T, Yamada Y, Hyodo A, Nose T, et al. The role of thallium-201 single photon emission tomography in the investigation and characterization of brain tumors in man and their response to treatment.Eur J Nucl Med 1993; 20: 39–45.

    Article  PubMed  CAS  Google Scholar 

  26. Seo H, Sato K, Fujita T, Yamada K, Nakai O, Komatani A. Sequential changes in SPECT using201Tl chloride during the treatment of intracranial gliomas.No To Shinkei 1993; 45: 537–543. (in Japanese)

    PubMed  CAS  Google Scholar 

  27. Tomura N, Kobayashi M, Seino Y, Ishikawa H, Watarai J, Kato T, et al. Usefulness of201TlCl-SPECT in the evaluation of radiation and chemotherapy for brain tumors.Nippon Igaku Hoshasen Gakkai Zasshi 1993; 53: 484–486. (in Japanese)

    PubMed  CAS  Google Scholar 

  28. Kojima Y, Kuwana N, Noji M, Tosa J. Differentiation of malignant glioma and metastatic brain tumor by thallium-201 single photon emission computed tomography.Neurol Med Chir (Tokyo) 1994; 34 (9): 588–592.

    Article  CAS  Google Scholar 

  29. Kaplan WD, Takvorian T, Morris JH, Rumbaugh CL, Connolly BT, Atkins HL. Thallium-201 brain tumor imaging: comparative study with pathologic correlation.J Nucl Med 1987; 28: 47–52.

    PubMed  CAS  Google Scholar 

  30. Lorberboym M, Baram J, Feibel M, Hercberg A, Lieberman L. A prospective evaluation of thallium-201 single photon emission computerized tomography for brain tumor burden.Int Radiat Oncol Biol Phys 1995; 32: 249–254.

    CAS  Google Scholar 

  31. Ohnishi H, Koizumi K, Uchiyama G, Yamaguchi M, Okada J, Ogata H, et al. Evaluation of malignancy and viability of brain tumors by201Tl SPECT: the correlation between201Tl SPECT and pathology, clinical progress and the intensity of enhancement on CT images.Nippon Igakun Hoshasen Gakkai Zasshi 1994; 54: 1388–1398. (in Japanese)

    CAS  Google Scholar 

  32. Front D. Scintigraphic assessment of vascularity and bloodtissue barrier of human brain tumors.J Neural Neurosurg Psychiatry 1978; 41: 18–23.

    Article  CAS  Google Scholar 

  33. Nakagawara J, Fukuoka S, Takahashi S, Takahashi M, Satoh K, Suematsu K, et al. Assessment of vascularity and permeability in brain tumor using SPECT and99mTc-DTPA-human albumin in relation to201Tl SPECT.KAKU IGAKU (Jpn J Nucl Med) 1993; 31: 117–124. (in Japanese)

    Google Scholar 

  34. Sehweil AM, Mckillop JH, Milroy R, Wilson R, Abdel-Dayem HM, Omar YT. Mechanism of201Tl uptake in tumors.Eur J Nucl Med 1989; 15: 376–379

    Article  PubMed  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Oral Surgery, Department of Oral Restitution, Division of Oral Health Sciences, Graduate School, Tokyo Medical and Dental University, Tokyo, Japan

    Aya Suzuki

  2. Division of Nuclear Medicine, Chiba Cancer Center, 666-2, Nitona-cho, Chuo-ku, 260-8717, Chiba, Japan

    Takashi Togawa, Junpei Kuyama & Tadaki Nakahara

  3. Division of Neurological Surgery, Chiba Cancer Center, Chiba, Japan

    Toshihiko Iuchi, Masaru Oga & Katsunobu Osato

  4. Division of Surgical Pathology, Chiba Cancer Center, Chiba, Japan

    Toshinao Takenouchi

Authors
  1. Aya Suzuki
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Takashi Togawa
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Junpei Kuyama
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Tadaki Nakahara
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Toshihiko Iuchi
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Masaru Oga
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Katsunobu Osato
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Toshinao Takenouchi
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Aya Suzuki.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Suzuki, A., Togawa, T., Kuyama, J. et al. Extraosseous accumulation of bone scanning agents in malignant brain tumors: Comparison to semi-quantitative evaluation with99mTc SPECT/201Tl SPECT and histological findings. Ann Nucl Med 17, 387–392 (2003). https://doi.org/10.1007/BF03006606

Download citation

  • Received:

  • Accepted:

  • Issue Date:

  • DOI: https://doi.org/10.1007/BF03006606

Key words

Search

Navigation