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Absence of thallium-201 brain uptake in progressive multifocal leukoencephalopathy in AIDS patients.
Iranzo A; Marti-Fabregas J; Domingo P; Catafau A; Molet J; Moreno A;
December 30, 1999
Acta Neurol Scand. 1999 Aug;100(2):102-5. Unique Identifier : AIDSLINE

OBJECTIVE: To evaluate the presence of thallium-201 brain uptake determined by thallium-201 brain SPECT (Tl-201 SPECT) in patients with progressive multifocal leukoencephalopathy (PML) and AIDS. MATERIAL AND METHODS: Six AIDS patients with stereotactic biopsy diagnosis of PML were prospectively evaluated with Tl-201 SPECT, Magnetic Resonance Imaging (MRI), and proton magnetic resonance spectroscopy (1H-MRS). Tl-201 SPECT results were compared with 2 patients with AIDS and biopsy proven primary CNS lymphoma. RESULTS: In all patients with PML, Tl-201 SPECT studies showed lack of uptake while MRI demonstrated subcortical white matter focal brain lesions and 1H-MRS disclosed metabolic abnormalities. Intense thallium uptake (uptake ratios of 3.2 and 5.6) was demonstrated in the 2 patients with primary CNS lymphoma. CONCLUSIONS: The present study shows that PML lesions are not detectable on Tl-201 SPECT while MRI and 1H-MRS demonstrate abnormalities, and intense thallium-201 uptake may be detected in primary CNS lymphoma. These results suggest that Tl-201 SPECT is a method which, combined with other non-invasive techniques such as MRI and 1H-MRS, may help in the diagnostic approach of PML and to differentiate PML from other high proliferative brain lesions characterized by positive thallium uptake.

JOURNAL ARTICLE Adult AIDS Dementia Complex/*RADIONUCLIDE IMAGING AIDS-Related Opportunistic Infections/*RADIONUCLIDE IMAGING Brain/RADIONUCLIDE IMAGING Brain Neoplasms/RADIONUCLIDE IMAGING Diagnosis, Differential Energy Metabolism/PHYSIOLOGY Female Human Leukoencephalopathy, Progressive Multifocal/*RADIONUCLIDE IMAGING Lymphoma, AIDS-Related/RADIONUCLIDE IMAGING Magnetic Resonance Imaging Male Middle Age Neurologic Examination Nuclear Magnetic Resonance Support, Non-U.S. Gov't Thallium Radioisotopes/DIAGNOSTIC USE *Tomography, Emission-Computed, Single-Photon