technetium-tc-99m-gluceptate and Glioma

This study aimed to evaluate and compare the role of Tc-GH SPECT/CT and F-FDOPA PET/CT for diagnosing recurrence in patients with glioma.. Thirty patients with histopathologically proven glioma (glioblastoma multiforme, 14; grade III, 6; grade II, 8; and grade I, 2), who presented with clinical and/or imaging suspicion of recurrence were prospectively evaluated. They were primarily treated with surgery and radiotherapy with or without chemotherapy. Each patient underwent Tc-GH SPECT/CT and F-FDOPA PET/CT within a span of 15 days. Images were evaluated qualitatively and quantitatively by 2 experienced nuclear medicine physicians in consensus. Histopathology and/or clinical/imaging follow-up were used as reference standard.. Based on reference standard, 22 patients were positive and 8 were negative for recurrence. Tc-GH SPECT/CT was positive for recurrence in 22 and negative in 8 patients. F-FDOPA PET/CT scan was positive for recurrence in 23 and negative in 7 patients. Sensitivity, specificity, and accuracy were 86.4%, 62.5%, and 80% for Tc-GH SPECT/CT and 100%, 87.5%, and 96% for F-FDOPA PET/CT, respectively. No significant difference was found between Tc-GH SPECT/CT and F-FDOPA PET/CT overall (P = 1.00), as well as for low-grade (P = 0.250) or high-grade tumors (P = 0.50). Significant correlation was noted between tumor-brain of Tc-GH with both tumor-striatum (r = 0.371; P = 0.044) and tumor-cerebellum ratio of F-FDOPA (r = 0.369; P = 0.045).. For detection of recurrence in glioma patients, Tc-GH SPECT/CT is not inferior to F-FDOPA PET/CT and can be used as a low-cost alternative.

Topics: Brain Neoplasms; Dihydroxyphenylalanine; Female; Glioma; Humans; Male; Multimodal Imaging; Organotechnetium Compounds; Pilot Projects; Positron-Emission Tomography; Prospective Studies; Recurrence; Sugar Acids; Tomography, Emission-Computed, Single-Photon; Tomography, X-Ray Computed

Early and correct diagnosis of tumor recurrence and its differentiation from therapy-related changes is crucial for prompt and adequate management of glioma patients. The purpose of this study was to compare the efficacies of Tc-99m glucoheptonate (GHA) single photon emission tomography (SPECT) and F-18 fluorodeoxyglucose (FDG) positron emission tomography/computed tomography (PET/CT) in detection of recurrence in patients with glioma.. A total of 90 patients with histopathologically proven glioma who had suspicion of recurrence clinically or on magnetic resonance imaging were evaluated using Tc-99m GHA SPECT and FDG PET/CT. Combination of clinical follow-up, repeat imaging, and biopsy (when available) was taken as gold standard.. On the basis of gold standard, 59 patients were positive and 31 were negative for tumor recurrence. The sensitivity, specificity, and accuracy of GHA SPECT were 85%, 97%, and 89%, respectively, whereas those of FDG PET/CT were 70%, 97%, and 80%, respectively. On subgroup analysis, GHA SPECT performed better than FDG PET/CT in all grades except for grade II gliomas, where both were equally effective. In all, 15 patients had intermodality discordance, with GHA SPECT being correct in 13 of them.. GHA SPECT appears to be a better imaging modality than FDG PET/CT for detection of recurrent gliomas.

Topics: Adolescent; Adult; Aged; Child; Female; Fluorodeoxyglucose F18; Glioma; Humans; Male; Middle Aged; Organotechnetium Compounds; Positron-Emission Tomography; Prospective Studies; Recurrence; Sugar Acids; Tomography, Emission-Computed, Single-Photon; Tomography, X-Ray Computed; Young Adult

Experimental gliomas were induced in rats by prenatal exposure to ethyl nitrosourea. Changes in the blood-brain barrier were determined by the uptake of a water-soluble compound, 99mTc-glucoheptonate. Increased uptake of 99mTc-glucoheptonate was measured in intact tumors and in various sectors of dissected tumors. The extent of 99mTc-glucoheptonate uptake greatly varied among different tumors and among different sectors of the same tumor. Ultrastructural and cytochemical analysis of the capillary endothelial wall revealed major alterations in tight junctions, which became permeable to horseradish peroxidase. In brain tissue around the tumors, uptake of 99mTc-glucoheptonate and ultrastructure of tight junctions were comparable to normal brain capillaries. The results of the present study indicate that altered endothelial tight junctions may provide the main route of transport of 99mTc-glucoheptonate through the endothelial wall.

Topics: Animals; Blood-Brain Barrier; Brain Neoplasms; Glioma; Intercellular Junctions; Neoplasms, Experimental; Organotechnetium Compounds; Pinocytosis; Rats; Rats, Inbred F344; Sugar Acids

Radionuclide and computed tomographic (CT) scanning was performed for the long-term follow-up of 63 patients who had been treated for primary intracranial central nervous system tumors. This group included 23 children with supratentorial lesions and 40 with infratentorial lesions. The results of imaging were correlated with clinical assessment and the results of cytologic evaluation of the cerebrospinal fluid and, when available, surgical or autopsy findings. The sensitivity, specificity, and positive predictive value of both CT and radionuclide scanning were evaluated for each type of tumor. These two modalities play a complementary role in the long-term follow-up of children with primary intra-axial neoplasms.

Topics: Adolescent; Astrocytoma; Brain Neoplasms; Child; Child, Preschool; Diatrizoate Meglumine; Ependymoma; False Negative Reactions; False Positive Reactions; Female; Follow-Up Studies; Glioma; Humans; Infant; Male; Medulloblastoma; Organotechnetium Compounds; Pentetic Acid; Sugar Acids; Technetium; Technetium Tc 99m Pentetate; Time Factors; Tomography, Emission-Computed; Tomography, X-Ray Computed