Purpose: To determine whether thallium-201 brain single-photon emission CT could be used to make the distinction between central nervous system lymphoma and toxoplasma encephalitis, which may not be possible by routine MR and CT.
Methods: A total of 37 patients with acquired immunodeficiency syndrome who had intracranial mass lesions found during a 9-month prospective study by either MR or CT underwent further evaluation with Tl-201 brain single-photon emission CT.
Results: Twelve patients had increased intense focal Tl-201 uptake. All of these patients had either biopsy- or autopsy-proven lymphoma. Twenty-five of the patients studied had no Tl-201 brain uptake in the lesion(s); 24 of these patients had toxoplasma encephalitis on clinical follow-up. One patient with no Tl-201 uptake was found by cerebrospinal fluid analysis to have mycobacterium tuberculosis abscess.
Conclusion: Patients with acquired immunodeficiency syndrome who have intracranial mass lesions on MR or CT may benefit from Tl-201 brain single-photon emission CT because it can help distinguish between lymphoma and infectious lesions such as toxoplasma encephalitis.