title: Prospective comparison of (99m)Tc-GH SPECT/CT and (18)F-FDOPA PET/CT for detection of recurrent glioma: a pilot study.
abstract: OBJECTIVE
  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.
  
  
  METHODS
  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.
  
  
  RESULTS
  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).
  
  
  CONCLUSIONS
  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.
authors.affiliation: From the Departments of *Nuclear Medicine, and †Neurosurgery, All India Institute of Medical Sciences, New Delhi, India.
authors.forename: Sellam
authors.initials: S
authors.lastname: Karunanithi
authors.forename: Guru Pada
authors.initials: GP
authors.lastname: Bandopadhyaya
authors.forename: Punit
authors.initials: P
authors.lastname: Sharma
authors.forename: Abhishek
authors.initials: A
authors.lastname: Kumar
authors.forename: Suhas
authors.initials: S
authors.lastname: Singla
authors.forename: Arun
authors.initials: A
authors.lastname: Malhotra
authors.forename: Deepak Kumar
authors.initials: DK
authors.lastname: Gupta
authors.forename: Chandrasekhar
authors.initials: C
authors.lastname: Bal
mesh_terms: D001932:Brain Neoplasms / Q000000981:diagnostic imaging*; D004295:Dihydroxyphenylalanine / Q000031:analogs & derivatives*; D005260:Female; D005910:Glioma / Q000000981:diagnostic imaging*; D006801:Humans; D008297:Male; D064847:Multimodal Imaging; D015609:Organotechnetium Compounds; D010865:Pilot Projects; D049268:Positron-Emission Tomography; D011446:Prospective Studies; D012008:Recurrence; D013400:Sugar Acids; D015899:Tomography, Emission-Computed, Single-Photon; D014057:Tomography, X-Ray Computed
chemical_list: D015609:Organotechnetium Compounds; D013400:Sugar Acids; C043437:fluorodopa F 18; D004295:Dihydroxyphenylalanine; C100014:technetium Tc 99m gluceptate