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M9480435.TXT
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1994-08-20
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Document 0435
DOCN M9480435
TI Diagnosis of intracranial lymphoma in patients with AIDS: value of 201TI
single-photon emission computed tomography.
DT 9410
AU O'Malley JP; Ziessman HA; Kumar PN; Harkness BA; Tall JG; Pierce PF;
Department of Radiology, Georgetown University Hospital,; Washington, DC
20007.
SO AJR Am J Roentgenol. 1994 Aug;163(2):417-21. Unique Identifier :
AIDSLINE MED/94311132
AB OBJECTIVE. Although the prevalence of intracranial lymphoma is high
among patients with AIDS, current imaging techniques are not reliable
for differentiating this tumor from other common nonneoplastic lesions,
such as those seen in toxoplasmosis. The purpose of this study was to
prospectively investigate the use of 201Tl single-photon emission
computed tomography (SPECT) in identifying intracranial lymphoma in
patients with AIDS. SUBJECTS AND METHODS. Thirteen patients with AIDS
and intracranial masses underwent 201Tl imaging with a three-headed
SPECT camera. Sic of the 13 were subsequently proved to have lymphoma.
Studies were interpreted prospectively as showing tumor if uptake of
201Tl was increased in the region where the lesion was seen on MR
images. A lesion-to-nonlesion uptake ratio (counts/pixel) was calculated
retrospectively. RESULTS. The SPECT images of six patients were
interpreted prospectively as showing no lymphoma. Uptake ratios in these
six patients were 0.77-1.95 (mean, 1.45). In each, tumor was excluded as
a final diagnosis (four had toxoplasmosis, one had progressive
multifocal leukoencephalopathy, and one had venous angioma). Among the
seven patients with SPECT images interpreted as showing lymphoma, six
were later proved to have lymphoma (uptake ratio: mean, 3.65; range,
2.95-4.30; p < .005). The SPECT findings in the seventh patient were
classified as false-positive for tumor on the basis of the prospective
interpretation of the images; three concurrent infections were found at
autopsy. The uptake ratio in this patient was low (1.81), suggesting
that quantification might have diagnostic usefulness for improving
accuracy. CONCLUSION. This preliminary study indicates that 201Tl SPECT
might be a useful, noninvasive method for differentiating intracranial
lymphoma from nonneoplastic lesions in patients with AIDS.
DE Adult AIDS-Related Opportunistic Infections/RADIONUCLIDE IMAGING
Brain/PATHOLOGY/RADIONUCLIDE IMAGING Brain
Neoplasms/DIAGNOSIS/EPIDEMIOLOGY/*RADIONUCLIDE IMAGING Diagnosis,
Differential Female Human Lymphoma,
AIDS-Related/DIAGNOSIS/EPIDEMIOLOGY/*RADIONUCLIDE IMAGING Magnetic
Resonance Imaging Male Prospective Studies Retrospective Studies
Thallium Radioisotopes/DIAGNOSTIC USE Tomography, Emission-Computed,
Single-Photon Toxoplasmosis, Cerebral/RADIONUCLIDE IMAGING JOURNAL
ARTICLE
SOURCE: National Library of Medicine. NOTICE: This material may be
protected by Copyright Law (Title 17, U.S.Code).