Clinical History
37 year-old female with a history of low grade glioma. She is Status post radiotherapy and resection with a question of tumor recurrence versus radiation necrosis. Comparison made with the recent thallium brain study as well as MRI of the brain.
Technique
The patient received a 10 mCi dose of 18FDG and 45 minutes later brain imaging was performed with axial, coronal, and sagittal images reconstructed.
Findings
When compared to the recent thallium scan as well as the recent MRI there is an area of increased metabolic activity near the vertex of the brain just right of mid line which corresponds to the abnormality seen on the thallium and MRI studies. Using a contour value of 4.9 SUV, there is an area of increased activity with an area of 2.12 sq. cm with a
maximum SUV value of 7.48 and a mean SUV value of 5.59. The surrounding back ground activity is 4.0 SUV units.
Impressions
AREA OF INCREASED METABOLIC ACTIVITY JUST RIGHT OF MIDLINE NEAR THE VERTEX CORRESPONDING
TO THE RECENT MRI AND THALLIUM IMAGES. THE MAXIMUM SUV VALUE IS 7.48 WITH A MEAN OF 5.5
WHICH IS CONSISTENT WITH RECURRENT TUMOR.
201-Thallium Brain Scan
Clinical History
The patient is a 37 year-old female with low-grade glioma, status post radiotherapy, followed by resection and now with recent MRI that shows enhancement near the vertex on the right.
Technique
The patient received an injection of 4.5 mCi of thallium-201 and SPECT imaging was performed
45 minutes thereafter using a triple-head gamma.
Findings
There is a focus of increased thallium accumulation in the vertex of the brain, just to the right of midline near the juncture of the posterior frontal lobe and parietal lobe.
Impressions
AN ENHANCEMENT IS SEEN IN THE AREA IN QUESTION. WHILE THIS MAY REPRESENT TUMOR, RADIATION
NECROSIS HAS BEEN SHOWN TO ACCUMULATE THALLIUM. RECOMMENDATION IS FOR FOLLOW-UP
EXAMINATION WITH FDG PET.