title: Evaluation of intracranial space-occupying lesion with Tc99m-glucoheptonate brain single photon emission computed tomography in treatment-naïve patients.
abstract: BACKGROUND
  Glucoheptonate is a glucose analog with strong affinity for neoplastic brain tissues. Though extensively used as a tracer for detection of brain tumor recurrence, it's utility for characterization of intracranial lesions as neoplastic or otherwise has not been evaluated in treatment-naïve patients.
  
  
  OBJECTIVE
  The study was conducted to determine if glucoheptonate has sufficient specificity for neoplastic lesions of brain so that it can be utilized as a single photon emission computed tomography (SPECT)-tracer for differentiating neoplastic intracranial lesions from non-neoplastic ones in treatment-naïve patients.
  
  
  METHODS
  A cross-sectional analysis of treatment-naïve patients with intracranial space-occupying lesion done in a tertiary care hospital.
  
  
  METHODS
  Fifty-four consecutive patients with clinical and radiological features of space-occupying lesion were included in this study. Glucoheptonate brain SPECT was performed before any definitive therapeutic intervention. Histopathological verification of diagnosis was obtained in all cases.
  
  
  METHODS
  Descriptive statistics and student's 't' test.
  
  
  RESULTS
  Increased glucoheptonate uptake over the site of radiological lesion was noted in 41 patients and no uptake was noticed in 13 patients. Histopathology of 12 out of the 13 glucoheptonate non-avid lesions turned out to be non-neoplastic lesion; however, one lesion was reported as a Grade-2 astrocytoma. Histology from all the glucoheptonate concentrating lesions was of mitotic pathology. The sensitivity, specificity and accuracy of glucoheptonate for neoplastic lesion was 97.6%, 100% and 98.1%.
  
  
  CONCLUSIONS
  Glucoheptonate has high degree of specificity for neoplastic tissues of brain and may be used as a tracer for SPECT study to differentiate neoplastic intracranial lesions from non-neoplastic ones.
authors.affiliation: Department of Neurosugery, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, India.
authors.forename: S
authors.initials: S
authors.lastname: Jaiswal
authors.forename: S
authors.initials: S
authors.lastname: Barai
authors.forename: S
authors.initials: S
authors.lastname: Gambhir
authors.forename: M
authors.initials: M
authors.lastname: Ora
authors.forename: A K
authors.initials: AK
authors.lastname: Mahapatra
mesh_terms: D000328:Adult; D001932:Brain Neoplasms / Q000000981:diagnostic imaging*; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D008297:Male; D015609:Organotechnetium Compounds; D011237:Predictive Value of Tests; D019275:Radiopharmaceuticals; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D013400:Sugar Acids; D015899:Tomography, Emission-Computed, Single-Photon / Q000379:methods*
chemical_list: D015609:Organotechnetium Compounds; D019275:Radiopharmaceuticals; D013400:Sugar Acids; C100014:technetium Tc 99m gluceptate