Tc-99m glucoheptonate single photon emission computed tomography-computed tomography for detection of recurrent glioma: A prospective comparison with N-13 ammonia positron emission tomography-computed tomography

Abstract

Purpose of the Study: To assess the efficacies of Tc-99m glucoheptonate single photon emission computed tomography-computed tomography (Tc-99m GHA SPECT-CT) and N-13 ammonia positron emission tomography-computed tomography (N-13 NH 3 PET-CT) in detecting recurrent glioma. Materials and Methods: Fifty-five consecutive, histologically proven, and previously treated glioma patients (age, 38.9 ± 12.2 years; 61.8% males) presenting with clinical suspicion of recurrence were evaluated with Tc-99m GHA SPECT-CT and N-13 NH 3 PET-CT. Images were evaluated both qualitatively and semiquantitatively. A combination of clinicoradiological follow-up, repeat imaging, and/or biopsy (when available) was considered as the reference standard. Results: Based on the reference standard, 28/55 (50.9%) patients had recurrence. Sensitivity, specificity, positive predictive value, negative predictive value, accuracy of Tc-99m GHA SPECT-CT, and N-13 NH 3 PET-CT were 85.7%, 85.2%, 85.7%, 85.2%, 85.5% and 78.6%, 88.9%, 88.0%, 80.0%, 83.6%, respectively (concordant findings in 46 patients). The performances of the two modalities were equivalent both in overall and subgroup McNemar analyses ( P = 0.508, overall; P = 0.687, low grade; P = 1.000, high grade). Conclusion: Tc-99m GHA SPECT-CT is an alternative imaging modality equally efficacious as N-13 NH 3 PET-CT in detecting recurrent glioma.

Incremental utility of Tc-99m glucohepatonate single-photon emission computed tomography over 18F-flourodeoxyglucose positron emission tomography in diagnosis of brain tumor recurrence – Old is gold

“…[ 6 7 ] It has also been shown that hypoxia may induce increased expression of GLUT1 receptors on the cell membrane, and thus, hypoxic cells may also take up GHA. [ 6 ] Tc-99m GHA SPECT-CT could be used as an alternative imaging modality equally efficacious as N-13 ammonia PET-CT[ 8 ] or F-18 dihydroxyphenylalanine (DOPA)[ 9 ] in detecting recurrent glioma, particularly in our part of the world, where financial constraints may play an important factor while choosing the imaging modality. Some studies have also reported Tc-99m GHA as a better imaging modality than F-18 FDG PET/CT for the detection of recurrent gliomas.…”

The use of advanced neuroimaging modalities in the evaluation of low-grade glioma in adults: a literature review

“…58 Finally, SPECT may be a useful follow-up method, as both 99m Tc-GHA SPECT and nitrogen-13 ammonia ( 13 N-NH3) PET have proven valuable in identifying recurrent gliomas with an accuracy of 85.5% and 83.6%, respectively. 59 Regular surveillance SPECT may be a valuable adjunct to the regular clinic follow-up for patients in whom resection of a low-grade glioma was performed, with the understanding that it, like PET, exposes the patient to additional radiation.…”