Use of 99m-technetium-glucoheptonate as a tracer for brain tumor imaging: An overview of its strengths and pitfalls

Santra, Amburanjan; Kumar, Rakesh; Sharma, Punit

doi:10.4103/0972-3919.147525

Cited by 8 publications

(7 citation statements)

References 18 publications

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“…A cutoff value of 2.0 for T/N on Tc-99m GHA SPECT-CT was suggested to label a lesion as positive for active tumor recurrence. [2931] However, in our study, we found the cutoff level to be 4.24. As explained in the results, the performances of the two modalities were equivalent even on semiquantitative analysis.…”

Section: Discussioncontrasting

confidence: 68%

“…False negativity has also been seen in posterior fossa tumors due to high background activity and in Grade I tumors because of intact BBB. [31] As explained in the results, one of the 2 patients with false-negative findings on both the modalities and baseline MRI showed increased tracer uptake on the follow-up scans after 6 months. This could be due to small lesion size, normal perfusion, intact BBB, or a combination of these at the time of baseline scanning.…”

Section: Discussionmentioning

confidence: 74%

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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

et al. 2019

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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.

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Section: Discussioncontrasting

confidence: 68%

Section: Discussionmentioning

confidence: 74%

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

et al. 2019

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“…In a meta-analysis that evaluated the diagnostic ability of SPECT in differentiating glioma recurrence from radiation necrosis, the pooled sensitivity was 89% and the specificity 88% [58]. Other promising tracers for SPECT to differentiate tumor recurrence from radiation necrosis include pentavalent technetium-99m dimercaptosuccinic acid (Tc-99m (V) DMSA) [59], bis-methionine-DTPA (Tc MDM) [60], and 99m-technetium glucoheptonate ( 99m Tc-GHA) [61].…”

Section: Diagnostic Imaging Modalitiesmentioning

confidence: 99%

Radiation Necrosis, Pseudoprogression, Pseudoresponse, and Tumor Recurrence: Imaging Challenges for the Evaluation of Treated Gliomas

Zikou

Sioka

Alexiou

et al. 2018

Contrast Media & Molecular Imaging

166

131

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Glioblastoma (GBM) is the most common primary malignant type of brain neoplasm in adults and carries a dismal prognosis. The current standard of care for GBM is surgical excision followed by radiation therapy (RT) with concurrent and adjuvant temozolomide-based chemotherapy (TMZ) by six additional cycles. In addition, antiangiogenic therapy with an antivascular endothelial growth factor (VEGF) agent has been used for recurrent glioblastoma. Over the last years, new posttreatment entities such as pseudoprogression and pseudoresponse have been recognized, apart from radiation necrosis. This review article focuses on the role of different imaging techniques such as conventional magnetic resonance imaging (MRI), diffusion-weighted imaging (DWI), diffusion tensor imaging (DTI), dynamic contrast enhancement (DCE-MRI) and dynamic susceptibility contrast (DSE-MRI) perfusion, magnetic resonance spectroscopy (MRS), and PET/SPECT in differentiation of such treatment-related changes from tumor recurrence.

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“…Thirty patients had intermodality discordance, with Tc-99m GHA SPECT being correct in 23 of them. [ 35 36 ]…”

Section: Discussionmentioning

confidence: 99%

Evaluation of Technetium-99m glucoheptonate single photon emission computed tomography for brain tumor grading

2016

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Background:This study is designed to appraise the diagnostic value of technetium-99m glucoheptonate (Tc-99m GHA) single photon emission computed tomography (SPECT) in brain tumor grading.Subjects and Methods:The study was performed on 30 patients referred from the Department of Neurosurgery, who were from both urban and rural areas. Data were collected through interview, history taking, and clinical examination followed by recording the desired parameters and finally imaging. The study subjects were divided into five groups: Controls (n = 4), low-grade tumors (n = 8), high-grade tumors (n = 8), metastases (n = 5), and nonneoplastic lesions (n = 5). This division was based on the World Health Organization (WHO) classification postclinico-histological diagnosis. Each of the subjects underwent contrast-enhanced computed tomography/contrast-enhanced magnetic resonance and Tc-99m GHA SPECT preoperatively. All were followed up postoperatively, and histopathological reports were regarded as the gold standard for tumor grading wherever available.Results:It was found that high-grade tumors (Grades III/IV and IV/IV according to the WHO classification) showed significantly higher tumor to normal (T/N) ratios as well as Tmax/N ratios when compared with low-grade tumors (Grades I/IV and II/IV), metastases or nonneoplastic lesions.Conclusions:In summary, the results of this study suggest that in situations where a preoperative grading of tumor is required Tc-99m GHA can be used in tumor grading and its use should be encouraged. Semi-quantitative analysis using both T/N as well as Tmax/N can be used in differentiating high-grade tumors from low-grade ones.

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Use of 99m-technetium-glucoheptonate as a tracer for brain tumor imaging: An overview of its strengths and pitfalls

Cited by 8 publications

References 18 publications

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

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

Radiation Necrosis, Pseudoprogression, Pseudoresponse, and Tumor Recurrence: Imaging Challenges for the Evaluation of Treated Gliomas

Evaluation of Technetium-99m glucoheptonate single photon emission computed tomography for brain tumor grading

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