The diagnostic value of 123I-IMP SPECT in ocular adnexal lymphoma

Int Ophthalmol. 2022 Apr;42(4):1205-1212. doi: 10.1007/s10792-021-02105-4. Epub 2021 Nov 2.

Abstract

Background: N-isopropyl- (123I) p-iodoamphetamine (123I-IMP) is specifically accumulated in primary central nervous system lymphoma (PCNSL) during single-photon emission tomography (SPECT) and contributes to its diagnostic imaging. However, whether 123I-IMP is accumulated in ocular adnexal lymphoma (OAL), one of the malignant intraorbital tumors, remains unclear. This study aimed to evaluate the diagnostic value of 123I-IMP SPECT in OAL.

Methods: Between August 2005 and June 2020, 26 patients with intraorbital tumors underwent neurosurgery at the tertiary care center. Of these, 15 patients who underwent 123I-IMPSPECT before surgery were retrospectively examined. The region of interest was set in the cerebellum ipsilateral to the intraorbital tumor on 123I-IMP SPECT, and the tumor-to-cerebellum ratio (T/C ratio) was calculated using the following formula: T/C ratio = [accumulation of tumor (count/pixel)]/[accumulation of ipsilateral normal cerebellar hemisphere (count/pixel)].

Results: Six patients were included in the OAL group, who were pathologically diagnosed with extranodal marginal zone B-cell lymphoma of mucosa-associated lymphoid tissue (MALT lymphoma), diffuse large B-cell lymphoma (DLBCL), and plasmacytoma. The T/C ratio in the OAL group was statistically higher than that in the non-OAL group (p < 0.01). The optimal cutoff values for both groups were between 0.76 and < 0.93. The sensitivity and specificity were 1.00, respectively.

Conclusions: 123I-IMP SPECT is useful as one of the examinations in the differential diagnoses of OAL, because it showed a significantly higher accumulation in OAL group than in non-OAL group.

Keywords: Intraorbital tumor; N-isopropyl-123I-ρ-iodoamphetamine; Ocular adnexal lymphoma; Single-photon emission tomography.

MeSH terms

  • Eye Neoplasms* / diagnosis
  • Humans
  • Iodine Radioisotopes
  • Lymphoma, B-Cell, Marginal Zone* / diagnosis
  • Retrospective Studies
  • Tomography, Emission-Computed, Single-Photon

Substances

  • Iodine Radioisotopes
  • Iodine-123