title: Detection of recurrence in glioma: a comparative prospective study between Tc-99m GHA SPECT and F-18 FDG PET/CT.
abstract: BACKGROUND
  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.
  
  
  METHODS
  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.
  
  
  RESULTS
  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.
  
  
  CONCLUSIONS
  GHA SPECT appears to be a better imaging modality than FDG PET/CT for detection of recurrent gliomas.
authors.affiliation: Department of Nuclear Medicine, Medical College Kolkata, Kolkata, India.
authors.forename: Amburanjan
authors.initials: A
authors.lastname: Santra
authors.forename: Rakesh
authors.initials: R
authors.lastname: Kumar
authors.forename: Punit
authors.initials: P
authors.lastname: Sharma
authors.forename: Chandrashekhar
authors.initials: C
authors.lastname: Bal
authors.forename: Pramod Kumar
authors.initials: PK
authors.lastname: Julka
authors.forename: Arun
authors.initials: A
authors.lastname: Malhotra
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D005260:Female; D019788:Fluorodeoxyglucose F18; D005910:Glioma / Q000000981:diagnostic imaging* / Q000473:pathology; D006801:Humans; D008297:Male; D008875:Middle Aged; D015609:Organotechnetium Compounds; D049268:Positron-Emission Tomography / Q000379:methods*; D011446:Prospective Studies; D012008:Recurrence; D013400:Sugar Acids; D015899:Tomography, Emission-Computed, Single-Photon / Q000379:methods*; D014057:Tomography, X-Ray Computed / Q000379:methods*; D055815:Young Adult
chemical_list: D015609:Organotechnetium Compounds; D013400:Sugar Acids; D019788:Fluorodeoxyglucose F18; C100014:technetium Tc 99m gluceptate