Published online before print September 19, 2002, 10.1148/radiol.2252011431
(Radiology 2002;225:567.)
A more recent version of this article appeared on November 1, 2002
Noninvasive Grading of Untreated Gliomas: A Comparative Study of MR Imaging and 3-(Iodine 123)-L-
-methyltyrosine SPECT1
Burkhard Riemann, MD,
Karsten Papke, MD,
Norbert Hoess, MD,
Torsten Kuwert, MD,
Matthias Weckesser, MD,
Peter Matheja, MD,
Hansdetlef Wassmann, MD,
Walter Heindel, MD and
Otmar Schober, MD, PhD
1 From the Departments of Nuclear Medicine (B.R., M.W., P.M., O.S.), Clinical Radiology (K.P., W.H.), and Neurosurgery (N.H., H.W.), University of Münster, Albert-Schweitzer-Strasse 33, 48129 Münster, Germany; and Department of Nuclear Medicine, University of Erlangen-Nürnberg, Germany (T.K.). Received August 27, 2001; revision requested October 17; final revision received April 8, 2002; accepted April 26. Address correspondence to B.R. (e-mail: riemanb@uni-muenster.de).
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Figure 1. Patient 3. Left: Transverse SPECT image shows 123I-IMT uptake in a left temporo-occipital astrocytoma (grade II). On the middle transverse T2-weighted 2,700/90 MR image, the same tumor (arrow) appears hypointense. On the right transverse gadolinium-enhanced T1-weighted 630/15 MR image, the tumor shows no contrast enhancement.
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Figure 2. Patient 32. Left: Transverse SPECT image shows 123I-IMT uptake in a right frontal astrocytoma (grade IV, patient 32). On the middle transverse T2-weighted 2,700/90 MR image, the partly cystic and partly necrotic tumor (arrows) appears inhomogenous. On the right transverse T1-weighted gadolinium-enhanced 630/15 MR image, the tumor shows marked contrast enhancement.
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Figure 3. Graph shows correlation between the mean MR imaging score of all patients and the histopathologic grade. Mean values ± SDs (vertical lines) were 0.80 ± 0.36 in grades I and II gliomas, 1.31 ± 0.29 in grade III gliomas, and 1.53 ± 0.40 in grade IV gliomas. Dots represent individual untreated gliomas.
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Figure 4. Graph shows correlation between the 123I-IMT uptake index of all patients and the histopathologic grade. Mean values ± SDs (vertical lines) were 1.91 ± 0.73 in grades I and II gliomas, 2.71 ± 1.01 in grade III gliomas, and 2.70 ± 0.72 in grade IV gliomas. Dots represent individual untreated gliomas.
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Figure 5. Graph shows mean MR imaging score and amino acid uptake in untreated gliomas. Line A denotes the threshold of discrimination between high- and low-grade gliomas for the mean MR imaging score, and line B denotes the corresponding threshold for 123I-IMT SPECT. Dots indicate individual untreated gliomas. Diagonal line represents linear regression.
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Figure 6. Receiver operating characteristic curve for discrimination between patients with high- and low-grade gliomas by using the mean MR imaging score and the 123I-IMT uptake index. The areas under the curves are commonly used to evaluate the quality of a diagnostic test independent of an arbitrarily chosen threshold of discrimination. The areas under the curves were 0.90 for the mean MR imaging score and 0.81 for the 123I-IMT uptake index. There was no statistically significant difference between the receiver operating characteristic curves for both diagnostic procedures (area test value = 1.2551; P = .21).
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Copyright © 2002 by the Radiological Society of North America.
