Evaluation of Technetium-99m glucoheptonate single photon emission computed tomography for brain tumor grading

Abstract

Background:This study is designed to appraise the diagnostic value of technetium-99m glucoheptonate (Tc-99m GHA) single photon emission computed tomography (SPECT) in brain tumor grading.Subjects and Methods:The study was performed on 30 patients referred from the Department of Neurosurgery, who were from both urban and rural areas. Data were collected through interview, history taking, and clinical examination followed by recording the desired parameters and finally imaging. The study subjects were divided into five groups: Controls (n = 4), low-grade tumors (n = 8), high-grade tumors (n = 8), metastases (n = 5), and nonneoplastic lesions (n = 5). This division was based on the World Health Organization (WHO) classification postclinico-histological diagnosis. Each of the subjects underwent contrast-enhanced computed tomography/contrast-enhanced magnetic resonance and Tc-99m GHA SPECT preoperatively. All were followed up postoperatively, and histopathological reports were regarded as the gold standard for tumor grading wherever available.Results:It was found that high-grade tumors (Grades III/IV and IV/IV according to the WHO classification) showed significantly higher tumor to normal (T/N) ratios as well as Tmax/N ratios when compared with low-grade tumors (Grades I/IV and II/IV), metastases or nonneoplastic lesions.Conclusions:In summary, the results of this study suggest that in situations where a preoperative grading of tumor is required Tc-99m GHA can be used in tumor grading and its use should be encouraged. Semi-quantitative analysis using both T/N as well as Tmax/N can be used in differentiating high-grade tumors from low-grade ones.

18F-FDG PET/CT IN THE EVALUATION OF ICSOLs

“…Cancers lead to 9% of deaths worldwide and are the second cause of death in developed countries, next only to cardiovascular diseases. 6 It comes as the 4 th largest cause of mortality (6%) in less developed countries. 6 CNS tumors were regarded earlier as relatively rare; however, with newer imaging modalities, it became clear that they accounted for 1.2% of autopsied deaths and 9% of cancers.…”

“…6 It comes as the 4 th largest cause of mortality (6%) in less developed countries. 6 CNS tumors were regarded earlier as relatively rare; however, with newer imaging modalities, it became clear that they accounted for 1.2% of autopsied deaths and 9% of cancers. Gliomas are central nervous system tumors derived from the glial cells representing the most common primary central nervous system tumors.…”

“…Tc-99m glucoheptonate, Tc-99m tetrofosmin, Tc-99m sestamibi, & Thallium-201 distinguished brain tumors which involved multiple ways of uptake in addition to blood-brain barrier (BBB) disruption. [3][4][5][6] The development of radiotracer labelled metabolites like 18F-FDG and better multimodality imaging like PET/ CT & PET/MRI have revolutionized brain lesions' early detection and characterization. [7][8][9][10][11][12][13][14][15][16][17][18][19][20][21] Our work aimed to evaluate the semiquantitative estimation of uptake of 18F-FDG in tumor localization, characterization, grading and delineating brain tumors from non-neoplastic ring-enhancing lesions helping patient management.…”

Magnetic Resonance Spectroscopy and Single-Photon Emission Computed Tomography in the Evaluation of Cerebral Tumors: A Case Report

“…Brain SPECT with Tc-99m was introduced in 1960s showing markedly the location of the tumor by demonstrating the disruption of the blood barrier in the pathological area [19]. Several radiopharmaceutical agents have been used until today such as Tc-99m diethylenetriaminepentaacetic acid (DTPA), Tc-99m glucoheptonate (Tc-99m GHA), thallium-201, Tc-99m tetrofosmin, and Tc-99m sestamibi [19].…”

“…Several radiopharmaceutical agents have been used until today such as Tc-99m diethylenetriaminepentaacetic acid (DTPA), Tc-99m glucoheptonate (Tc-99m GHA), thallium-201, Tc-99m tetrofosmin, and Tc-99m sestamibi [19]. The last decades this modality was repeatedly implemented for the detection of tumor recurrence or remnants in high grade gliomas and for brain tumors grading [19-23]. Furthermore, it was proved of significant value in the differentiation between tumor necrosis due to irradiation and recurrence in surgically treated high grade gliomas [24].…”