Clinical History
This is a 49 year old male with an oligodendroglioma. A recent MRI scan done on November 30, 2000 showed an interval increase in size of a lesion in the left parietal lobe. Differential diagnosis by MRI was radiation necrosis versus recurrent tumor. This is being done for further evaluation. There is also a second lesion in the left parietal white matter adjacent to the left lateral ventricle.
Technique
The patient was injected intravenously with 4.5 millicuries of 201-thallium chloride and SPECT imaging in multiple projections of the head were obtained.
Findings
There is an area of increased activity identified in the left posterior parietal lobe which correlates with the lesion on MRI and is consistent with residual or recurrent tumor. There is no evidence of increased activity adjacent to the left lateral ventricle in the area of the second lesion identified by MR. No other areas are identified.
Impressions
1. INCREASED ACTIVITY IN THE LEFT POSTERIOR PARIETAL GRAY MATTER WHICH CORRESPONDS WITH THE LESION ON THE MRI SCAN AND IS CONSISTENT WITH RESIDUAL OR RECURRENT TUMOR.
2. NO INCREASED ACTIVITY IDENTIFIED IN THE SECOND SMALL LESION ADJACENT TO THE LEFT LATERAL VENTRICLE. IF CLINICALLY INDICATED AND FURTHER EVALUATION IS WARRANTED, THIS COULD BE OBTAINED WITH A PET SCAN.
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