[en] Technetium-99m-Tetrofosmin (TF) is the tracer for single photon emission computed tomography (SPECT). It is commercially available in Japan and covered by Japanese health insurance only for ischemic heart diseases. In other countries, TF has been used for imaging of various brain tumors. We examined TF SPECT in patients with brain tumor and compared the image findings with other radiological image findings. The study population included 11 patients (4 men and 7 women) aged 48-87 years. The histological tumor diagnoses were as follows: glioblastoma multiforme (GBM; n=7), anaplastic oligoastrocytoma (n=1), meningioma (n=1), and metastasis (n=2). SPECT images were acquired using multidetector SPECT camera (E.CAM, Siemens) at 15 min and 3 h after intravenous injection of 740MBq of TF or 74MBq of Thallium chloride (Tl). The tracer uptakes of TF and Tl were almost similar. Both TF and Tl delayed SPECT images showed hot uptake in the tumors of GBM patients. In meningioma patients, both TF and Tl early images showed hot uptake, whereas the tracers were washed out in delayed images. TF SPECT images were clearer than Tl SPECT images. There was physiological uptake of TF in the normal choroid plexus; this finding helps in understanding the spatial correlation between the tumors and ventricles. No side effects with TF injection were observed. TF SPECT is better and more useful than Tl SPECT to diagnose location, extent, malignancy, and viability of tumors as well as the effects of anticancer therapies. (author)

[en] Arthroscopic or open surgical findings in 21 wrists with chronic ulnar painful lesion were compared both with arthrography and magnetic resonance (MR) imaging results to evaluate the accuracy of the two diagnostic procedures in the detection of triangular fibrocartilage complex (TFCC) lesions. Arthrography investigations were performed for the 20 wrists but one that had allergy for iodine and MR imagings were performed for the recent 12 wrists. Arthrography and magnetic resonance (MR) imaging were almost equally useful for the detection of the TFCC injury and their injury sites. (author)

[en] The expression of P-glycoprotein was investigated imunohistochemically in 26 brain tumor tissues and compared with the findings of technetium-99m methoxyisobutylisonitrile single photon emission computed tomography (^99mTc-MIBI SPECT) to clarify the effect of P-glycoprotein on the diagnostic accuracy. P-glycoprotein labeling index of both tumor cells and vascular endothelial cells showed no clear relationship with the findings of ^99mTc-MIBI SPECT imaging. Expression of P-glycoprotein has no effect on the diagnostic accuracy of ^99mTc-MIBI SPECT. (author)

[en] Magnetic resonance (MR) images of five patients with osteomas of the skull and six patients with other primary skull tumors were reviewed. All osteomas appeared as low-intensity areas on T₁-weighted images. T₂-weighted images showed homogeneous low-intensity areas in two dense osteomas, a high-intensity area in one spongy osteoma, and mixed intensity areas in two mixed spongy and dense osteomas, respectively. The signal intensities of osteomas on T₂-weighted MR images correlated well with the histological findings. Other skull tumors showed no specific MR imaging appearance. (author)

[en] Technetium 99m methoxyisobutylisonitrile (Tc-99m-MIBI) is a new tracer developed for the diagnosis of ischemic heart disease. We have reported the feasibility of Tc-99m-MIBI single photon emission computed tomography (SPECT) in evaluating the malignancy and the viability of the brain tumors. In this study, the authors investigated the role of Tc-99m-MIBI SPECT in the diagnosis of recurrent malignant brain tumor and radiation necrosis. We examined 20 adult patients with malignant brain tumors using Tc-99m-MIBI SPECT. All patients underwent surgery and radiation therapy. Recurrent malignant tumor showed high uptake of Tc-99m-MIBI while radiation necrosis revealed relative low uptake of Tc-99m-MIBI. However, there were false negative and positive cases. The group with TTP less than 12 month showed high uptake of Tc-99m-MIBI. The general behavior of Tc-99 m-MIBI was almost same as that of 201-Tl, however, the image resolution of Tc-99m-MIBI was better than that of 201-Tl. Tc-99m-MIBI SPECT had limitations in the histological diagnosis of recurrent tumor, however it was useful for the estimation of the prognosis. (author)

[en] Central nervous system (CNS) lymphoma show relatively specific neuroimaging findings. Some literatures reports have documented the diagnostic usefulness of I¹²³-iofetamine (IMP) single photon emission computed tomography (SPECT) and diffusion-weighted imaging (DWI) MRI. Each imaging methods, however, has limitations. We used I¹²³-IMP SPECT, DWI MRI, Tl SPECT, Ga scintigraphy and tumor marker, IL2R and β2MG in blood and/or cerebrospinal fluid (CSF) for the diagnosis of CNS lymphoma. In this report, we analyzed diagnostic utility of these multi-modal imaging techniques in 19 patients with CNS lymphoma. This study included 19 patients of surgically confirmed CNS lymphoma. Pathological diagnosis included 18 Diffuse large B-cell lymphoma (DLBL) and 1 Burkitt lymphoma. Male:Female rate was 12:7. Patient age ranged from 16 to 76 and median age was 64 years old. After the intravenous injection of 222 MBq of IMP, early (15 min) and delayed (3 hours) SPECT images were acquired using multi-detector SPECT machine. MRIs were acquired with 1.5 Tesla machine, and b value 1000 was used for DWI. Tumor markers in blood and/or CSF were measured. In some patients, Tl SPECT and Ga scintigraphy were examined. IMP SPECT sensitivity for CNS lymphoma was 64% (11/17). DWI sensitivity was 90% (9/10). Patients on corticosteroids showed negative results with both IMP SPECT and DWI. The sensitivity of IL2R in blood was 21% (4/19), but corticosteroids did not influence the results. The sensitivity of β2MG in blood was 0% (0/7). The sensitivity of β2MG in CSF was 100% (3/3). The sensitivity of Ga scintigraphy was 67% (4/6). The sensitivity of Tl SPECT was 100% (9/9). IMP SPECT and DWI are useful for the diagnosis of CNS lymphoma. We should take multi-modal images before corticosteroid therapy because the treatment affects diagnostic efficacy of imagings. (author)

[en] The use of autologous lymphokine-activated killer (LAK) cells to treat malignant brain tumors was evaluated in 10 patients, one with metastatic malignant melanoma and nine with malignant glioma. LAK cells were obtained by culturing autologous peripheral blood lymphocytes with human recombinant interleukin-2 (rIL-2) for 7-28 days. All patients underwent surgery to remove as much tumor as possible and an Ommaya reservoir was implaced in the tumor cavity. Two of the 10 patients had received radiotherapy elsewhere, so were treated with LAK cells alone. Eight patients were treated with a combination of LAK cells and radiotherapy, using 1.8-2.0 Gy fractions given five times a week with a total dosage between 54 and 65 Gy. LAK cells and rIL-2 were injected to the tumor cavity via the Ommaya reservoir once a week for inpatients and once a month for outpatients. The duration of the LAK therapy ranged from 3 to 23 months (mean 13.7 mos). Neuroimaging evaluation revealed two complete responses, three partial responses, four no changes, and one progressive disease. In one patient with pontine glioma, the Karnofsky performance score was raised from 20 to 60. There were no side effects after the injection of LAK cells and rIL-2. The results suggest low-dose LAK therapy is a useful and safe treatment modality for malignant brain tumors. (author)

[en] Short communication

[en] In a previous study, we reported that sodium borocaptate (BSH) uptake was enhanced in combination with buthionine sulfoximine (BSO) in vitro. This report investigated the effect of the combination in vivo. In our results, the boron levels in blood and tissues were preserved highly in the BSO +BSH group, in comparison with the BSH only group. BSO has the potential to improve boron uptake in BNCT. (author)

[en] ¹²³I-iodoamphetamine Single Photon Emission Computed Tomography (IMP SPECT) is used to evaluate cerebral blood flow. However, application of IMP SPECT to patients with brain tumors has been rarely reported. Primary central nervous system lymphoma (PCNSL) is a rare tumor that shows delayed IMP uptake. The relatively low spatial resolution of SPECT is a clinical problem in diagnosing brain tumors. We examined anatomically standardized statistical mapping of IMP SPECT in patients with brain lesions. This study included 49 IMP SPECT images for 49 patients with brain lesions: 20 PCNSL, 1 Burkitt's lymphoma, 14 glioma, 4 other tumor, 7 inflammatory disease and 3 without any pathological diagnosis but a clinical diagnosis of PCNSL. After intravenous injection of 222 MBq of ¹²³I-IMP, early (15 minutes) and delayed (4 hours) images were acquired using a multi-detector SPECT machine. All SPECT data were transferred to a newly developed software program iNeurostat+ (Nihon Medi-physics). SPECT data were anatomically standardized on normal brain images. Regions of increased uptake of IMP were statistically mapped on the tomographic images of normal brain. Eighteen patients showed high uptake in the delayed IMP SPECT images (16 PCNSL, 2 unknown). Other tumor or diseases did not show high uptake of delayed IMP SPECT, so there were no false positives. Four patients with pathologically proven PCNSL showed no uptake in original IMP SPECT. These tumors were too small to detect in IMP SPECT. However, statistical mapping revealed IMP uptake in 18 of 20 pathologically verified PCNSL patients. A heterogeneous IMP uptake was seen in homogenous tumors in MRI. For patients with a hot IMP uptake, statistical mapping showed clearer uptake. IMP SPECT is a sensitive test to diagnose of PCNSL, although it produced false negative results for small posterior fossa tumor. Anatomically standardized statistical mapping is therefore considered to be a useful method for improving the diagnostic sensitivity, spatial resolution, and accuracy of IMP SPECT for brain lesions. (author)