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ORIGINAL ARTICLE
Year : 2019  |  Volume : 34  |  Issue : 2  |  Page : 107-117

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


1 Department of Nuclear Medicine, Institute of Liver and Biliary Sciences; Department of Nuclear Medicine, All India Institute of Medical Sciences, New Delhi, India
2 Department of Nuclear Medicine, All India Institute of Medical Sciences, New Delhi, India

Correspondence Address:
Dr. Chandrasekhar Bal
Department of Nuclear Medicine, All India Institute of Medical Sciences, Ansari Nagar, New Delhi - 110 029
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/ijnm.IJNM_164_18

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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 NH3PET-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 NH3PET-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 NH3PET-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 NH3PET-CT in detecting recurrent glioma.


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