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• W2555797672 abstract "1514 Objectives To evaluate the diagnostic utility of bis-methionine-DTPA (99mTc-MDM) and its comparative evaluation with contrast-enhanced magnetic resonance Imaging (ceMRI) and 18F-fluorothymidine-PET (18F-FLT-PET) for the detection of recurrent/residual glioma. Methods This prospective study included 53 patients (34M: 19F, mean age= 42.3 ±15.03yrs; range=8-72 yrs) having post-operative clinical suspicion of recurrent/residual glioma (34- Glioblastoma Multiforme-G-IV; 07-Astrocytoma/Oligodendroglioma-G-I/G-II; 08-Anaplastic Oligodendroglioma/Oligoastrocytoma-G-III; 04-Pilocytic astrocytoma-G-I) referred for 99mTc-MDM-SPECT and ceMRI at PGIMER, Chandigarh. 99mTc-MDM-SPECT and ceMRI was done in 41patients out of 53 after radical radiotherapy (RT) (54.0-60.0 Gy) with or without concurrent temozolomide and one patient was followed at 3-months. Sixteen (16/53) patients underwent F-18-FLT-PET and two underwent C-11-methionine PET. Twelve (12/53) patients underwent 99mTc-MDM-SPECT and ceMRI before RT and in which three patients underwent follow-up 99mTc-MDM-SPECT and ceMRI after 3-months post RT for RT response evaluation and one patient also underwent 99mTc-MIBI SPECT. Results The mean radio labeling efficiency of 99mTc labeled MDM was reserved to be 96.7± 1.6 %( n=64). MDM SPECT and ceMRI finding were concordant in 48 scans (25 positive & 23 negative). The findings were discordant in the remaining 9 patients, with positive ceMRI & negative MDM-SPECT in 5- scans and negative ceMRI & positive MDM-SPECT in 4-scans respectively. We observed positive 99mTc-MDM-SPECT, 18F-FLT-PET and ceMRI scan findings in 9/16 and negative in 5/16 patients respectively. In the remaining 2 of 16 patients, both 99mTc-MDM-SPECT and 18F-FLT-PET were positive but ceMRI was negative. We also observed that in one patient both 99mTc-MDM-SPECT and 99mTc-MIBI-SPECT was positive but ceMRI was negative for the evidence of recurrent/remnant disease. 99mTc-MDM-SPECT showed overall sensitivity, specificity, PPV, NPV and DA of 83.33% 85.19%, 86.21%, 82.14% & 84.2% respectively for the detection of recurrent/residual glioma. Conclusions Methionine localized in brain tumors through uptake by amino-acid transport (LAT-1) mechanism. The diagnostic utility of 99mTc-MDM-SPECT imaging was comparable with that of ceMRI and 18F-FLT-PET. The development of amino-acid based ‘SPECT’ radiotracers may offer an economical and reliable substitute to PET imaging which could be of special interest in peripheral hospitals/developing countries not having access to expensive PET/cyclotron technology. However, head to head comparison with gold standard 18F-FET-PET tracer and long-term follow-up will be useful for further validation of this SPECT tracer." @default.
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• W2555797672 date "2016-05-01" @default.
• W2555797672 modified "2023-09-26" @default.
• W2555797672 title "99mTc-MDM brain SPECT: A cost effective substitute for PET Imaging for diagnostic workup of residual/recurrent glioma" @default.
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