**2. Patients and methods**

This study included IMP SPECT images for 49 patients with brain lesions: 20 with PCNSL, one with Burkitt's lymphoma, 15 with glioma, two with meningioma, one with a metastatic tumor, two with multiple sclerosis (MS), five with cerebritis and three without any pathological diagnosis, but a clinical diagnosis of PCNSL. No patients had received prior radiation or chemotherapy for brain tumors. Three patients had previously received steroid medication at the time of IMP SPECT examination.

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We examined the normal reconstructed images and statistical mapping of IMP SPECT. After the intravenous injection of 222 Megabecquerel (MBq) of 123I-IMP, the early (15 minutes) and delayed (3 hours) images were acquired using a multi-detector SPECT machine (E.CAM, Siemens Medical, Erlangen, Germany) and a high resolution collimator (LEHR, Siemens Medical, Erlangen, Germany). The Butterworth pre-correction filter and the Chang method were used for pre- and post-attenuation corrections. The Ramp filter was used for reconstruc‐ tion. The image matrices, the pixel sizes and the slice thickness of the IMP SPECT were 128 x 128, 3.31 mm and 6.62 mm, respectively. All SPECT data were saved in the Digital Imaging and Communication in Medicine (DICOM) format. The DICOM data were transferred to a newly developed software program, the iNeurostat+ (Nihon Medi-physics, Hyogo, Japan), which runs on a Windows personal computer. The SPECT data were anatomically standar‐ dized on normal brain images. The increased uptakes of IMP were statistically mapped on the tomographic images of the normal brain. The image quality, diagnostic ability and imaging artifacts were evaluated by a visual inspection (Figure 1).

The statistical analysis was performed with the Chi-square test. Values of p < 0.05 were

New Application of 123I-Iodoamphetamine SPECT for the Diagnosis of Primary Central Nervous System Lymphoma

http://dx.doi.org/10.5772/58321

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A 58-year-old female had a Gd-enhanced MRI scan, which showed a homogenously enhanced tumor at the left putamen. Delayed IMP SPECT showed tumor uptake, however, other normal brain uptake was also detected. Statistical mapping of IMP SPECT data demonstrated hot tumor uptake and no uptake into the normal brain. A tumor biopsy revealed a pathological

**Fig 2: Case 1: 58 Woman: PCNSL**

IMP‐SPECT 4, 24, 48 hours

A 71-year-old female underwent a Gd-enhanced MRI scan, which showed a homogeneously enhanced tumor at the left cerebellum. Delayed IMP SPECT did not show clear uptake into the cerebellar lesion. Statistical mapping of IMP SPECT demonstrated clear uptake of IMP into

the tumor. The tumor was pathologically diagnosed as PCNSL by biopsy.

Mapping 24 hours

Gd‐MRI Statistical

considered to be significant.

**3. Representative cases**

**3.1. Case 1 (Figure 2)**

diagnosis of PCNSL.

**Figure 2.** 58 Woman: PCNSL

**3.2. Case 2 (Figure 3)**

**Fig 1: Automatic Process Flow of iNeurostat+** 

**Figure 1.** Automatic Process Flow of iNeurostat+

Magnetic resonance imaging (MRI) data were acquired with 1.5 Tesla instrument (Gyroscan NT Intera, Philips, Amsterdam, The Netherlands). The tumor diameters and size were measured using gadolinium-diethyltriaminepentaacetic acid (Gd-DTPA)-enhanced T1 weighted MRI.

The statistical analysis was performed with the Chi-square test. Values of p < 0.05 were considered to be significant.
