Reduced value of thallium-201 single-photon emission computed tomography in the management of HIV-related focal brain lesions in the era of highly active antiretroviral therapy

AIDS Research and Human Retroviruses
Maria Letizia GiancolaAndrea Antinori

Abstract

To evaluate the diagnostic value of thallium-201 single-photon emission computed tomography (201Tl SPECT) in the management of focal brain disorders in the era of highly active antiretroviral therapy (HAART), a validation study of diagnostic procedure was performed in a tertiary clinical care center in Italy. Thirty-eight consecutive HIV-infected patients with neurological impairment and focal brain lesions (FBL) were enrolled in a prospective evaluation and underwent diagnostic procedures according to a standardized protocol based on modified previously released guidelines. Six out of seven PCNSL presented high uptake at 201Tl SPECT [sensitivity 86% (95% CI 42-99); specificity 77% (95% CI 58-90); positive predictive value (PPV) 46% (95% CI 20-74); negative predictive value (NPV) 96% (95% CI 78-100)]. Among toxoplasmic encephalitis (TE) cases 14 showed no uptake and 5 showed an increased uptake [sensitivity 74% (95% CI 49-90); specificity 42% (95% CI 21-66); PPV 56% (95% CI 35-75); NPV 61% (95% CI 32-85)]. Patients taking HAART were more likely to display an increased uptake of 201Tl in the cerebral lesions than patients without HAART (OR 5.07; 95% CI 1.19-21.5). Considering only the patients with diagnosis of TE, 60% of patien...Continue Reading

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Citations

Jan 29, 2011·Neurotherapeutics : the Journal of the American Society for Experimental NeuroTherapeutics·David F TateJeffrey Dewey
Mar 17, 2006·Journal of Neurovirology·Antonella CingolaniAndrea Antinori
Aug 21, 2019·Journal of the International Association of Providers of AIDS Care·José Ernesto Vidal
Oct 2, 2019·Frontiers in Immunology·Timothy J HenrichHenry VanBrocklin
Aug 1, 2020·Current Neurology and Neuroscience Reports·Isabel Elicer
Oct 29, 2020·AJR. American Journal of Roentgenology·Charles MarcusGary D Marano
Nov 27, 2020·Clinical Microbiology Reviews·Hany M ElsheikhaXing-Quan Zhu

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