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Effect of Gamma Knife radiosurgery on acoustic neurinomas. Assessment by 99mTc-DTPA-human serum albumin- and 201TlCl-single photon emission computed tomography.

Single photon emission computed tomography (SPECT) was performed on 16 patients with acoustic neurinoma before and 1 and 2 years after Gamma Knife surgery. 201TICI-SPECT was used to determine tumor viability. Early and delayed images of 99mTc-DTPA-human serum albumin (99mTc-HSA-D)-SPECT were used to assess tumor vascularity and permeability, respectively. There was a statistically significant decrease in the 99mTc-HSA-D index of the early image at 1 year (p = 0.013) and at 2 years (p = 0.018) after Gamma Knife surgery. On the other hand, the 201Tl index and the 99mTc-HSA-D index of the delayed image were not significantly different from their pretreatment values. These observations demonstrate that a reduction in tumor vascularity without a decrease in tumor viability may be one of the effects of Gamma Knife surgery on acoustic neurinomas.