Department of Nuclear Medicine, Medical College Kolkata, Kolkata, India.
Clin Nucl Med. 2011 Aug;36(8):650-5. doi: 10.1097/RLU.0b013e318217aee0.
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.
早期、正确地诊断肿瘤复发并将其与治疗相关的变化区分开来，对于及时、充分地管理胶质瘤患者至关重要。本研究旨在比较 Tc-99m 葡庚糖酸盐（GHA）单光子发射断层扫描（SPECT）和 F-18 氟脱氧葡萄糖（FDG）正电子发射断层扫描/计算机断层扫描（PET/CT）在检测胶质瘤患者复发中的疗效。
共 90 例经组织病理学证实的胶质瘤患者，临床或磁共振成像怀疑复发，采用 Tc-99m GHA SPECT 和 FDG PET/CT 进行评估。以临床随访、重复成像和活检（如有）的综合结果作为金标准。
根据金标准，59 例患者肿瘤复发阳性，31 例患者肿瘤复发阴性。GHA SPECT 的敏感性、特异性和准确性分别为 85%、97%和 89%，而 FDG PET/CT 的敏感性、特异性和准确性分别为 70%、97%和 80%。亚组分析显示，除 II 级胶质瘤外，GHA SPECT 在所有分级中的表现均优于 FDG PET/CT，而 II 级胶质瘤两者的效果相当。总的来说，15 例患者存在两种模态之间的不一致，其中 13 例 GHA SPECT 的结果是正确的。
GHA SPECT 似乎是一种比 FDG PET/CT 更好的成像方式，用于检测复发性胶质瘤。
