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201Tl-SPECT and 1H-MRS study of benign lateral ventricle tumors: differential diagnosis of subependymoma

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Abstract

The introduction of computed tomography (CT) and magnetic resonance (MR) imaging has resulted in the detection of increasing numbers of asymptomatic intraventricular tumors. Establishing the correct preoperative diagnosis is important to prevent unnecessary surgical intervention. Our study includes nine cases of benign lateral ventricle tumors including two cases of central neurocytoma, two of subependymal giant cell astrocytoma, two of pilocytic astrocytoma and three of subependymoma treated surgically between 1996 and 2003. MR imaging, proton MR spectroscopy (1H-MRS) and thallium-201 single photon emission computed tomography (201Tl-SPECT) were performed in all patients. All three types of tumor demonstrated heterogeneous enhancement on MR imaging with gadolinium-diethylenetriamine pentaacetic acid (Gd-DTPA) and increased choline (Cho) peak and decreased N-acetyl aspartate (NAA) and creatine (Cre) peaks on 1H-MRS. 201Tl-SPECT showed high uptake of 201Tl without wash out in all cases of central neurocytoma, subependymal giant cell astrocytoma and pilocytic astrocytoma, but no uptake in cases of subependymoma. Absence of 201Tl uptake in contrast with enhancement on MR imaging and the 1H-MRS features of modest elevation of the Cho/Cre ratio, reduction of the NAA peak and presence of lactate/lipid peaks are characteristic features of subependymomas and useful to establish a preoperative diagnosis.

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Authors and Affiliations

  1. Department of Neurosurgery, Tohoku University Graduate School of Medicine, 1-1 Seiryo-machi, Aoba-ku, Sendai 980-8574, Japan

    Tomohiro Kawaguchi, Toshihiro Kumabe & Teiji Tominaga

  2. Department of Neurosurgery, Kohnan Hospital, Sendai, Japan

    Hiroaki Shimizu

  3. Department of Pathology, Tohoku University Graduate School of Medicine, Sendai, Japan

    Mika Watanabe

Authors
  1. Tomohiro Kawaguchi
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  2. Toshihiro Kumabe
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  3. Hiroaki Shimizu
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  4. Mika Watanabe
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  5. Teiji Tominaga
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Correspondence to Toshihiro Kumabe.

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Kawaguchi, T., Kumabe, T., Shimizu, H. et al. 201Tl-SPECT and 1H-MRS study of benign lateral ventricle tumors: differential diagnosis of subependymoma. Neurosurg Rev 28, 96–103 (2005). https://doi.org/10.1007/s10143-004-0353-6

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  • DOI: https://doi.org/10.1007/s10143-004-0353-6

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