Comparison between contrast-enhanced magnetic resonance imaging and technetium 99m glucohepatonic acid single photon emission computed tomography with histopathologic correlation in gliomas.

Abstract

OBJECTIVE:

: To determine and compare the accuracy of contrast-enhanced magnetic resonance imaging (MRI) and Technetium 99m glucohepatonic acid single photon emission computed tomography (Tc-GHA SPECT) in grading of gliomas, compared with neuropathologic findings.

MATERIALS AND METHODS:

: The study included 20 adult patients (13 men and 7 women) with clinical/radiological suspicion of brain tumor (glial tumor) who were subjected to magnetic resonance examination and Tc-GHA brain SPECT.The lesions were evaluated by using MRI imaging score, based on 9 MRI criteria. Based on the discrimination threshold of 0.9 for mean MRI score, the gliomas were graded as low- or high-grade glioma. The Tc-GHA SPECT retention index was calculated as the ratio between delayed and early uptake ratios. Based on the discrimination threshold of 1 for Tc-GHA SPECT retention index, the gliomas were graded as low- or high-grade glioma.The diagnosis was verified by means of histopathologic examination in all patients (open surgery in 19 patients and stereotactic biopsy in 1 patient). Correlation between MRI findings/scores, SPECT scores, and histopathologic grades was done in all the patients, and comparison between MRI and Tc-GHA SPECT was made using paired Student t test and correlation coefficient.

RESULTS:

: The study revealed significant difference between the mean MRI scores and early uptake ratio, delayed uptake ratio, and retention index of low-grade (grades I-II) and high-grade (grades III-IV) gliomas. No statistically significant difference could be demonstrated between the abilities of contrast-enhanced MRI and Tc-GHA SPECT to allow differentiation between high- and low-grade gliomas. The accuracy of MRI (78.4%), however, was slightly higher than that of Tc-GHA SPECT (73.68%). However, Tc-GHA SPECT allowed differentiation between high-grade gliomas (between grades III and IV gliomas).

CONCLUSIONS:

: The accuracy of contrast-enhanced MRI in the distinction of high- and low-grade malignancy was higher than that of Tc-GHA SPECT. The performance of Tc-GHA SPECT adds little in determining tumor grade when MRI is performed. However, it may act as a useful adjunct to differentiate between grades III and IV gliomas.

• Authors: R Ashok Kumar, Niranjan Khandelwal, Kushaljit Singh Sodhi, A Pathak, B R Mittal, B D Radotra, Sudha Suri
• Journal: Journal of computer assisted tomography (J Comput Assist Tomogr) 2006 Sep-Oct Vol. 30 Issue 5 Pg. 723-33 ISSN: 0363-8715 [Print] United States
• PMID: 16954918 (Publication Type: Clinical Trial, Comparative Study, Journal Article)

Chemical References

• Contrast Media
• Organotechnetium Compounds
• Radiopharmaceuticals
• technetium 99m glucohepatonic acid
• Technetium
• Gadolinium DTPA

Topics

• Adult
• Brain (diagnostic imaging, pathology, surgery)
• Brain Neoplasms (diagnosis, pathology, surgery)
• Contrast Media (administration & dosage)
• Female
• Gadolinium DTPA
• Glioma (diagnosis, pathology, surgery)
• Humans
• Image Enhancement (methods)
• Magnetic Resonance Imaging (methods)
• Male
• Middle Aged
• Neoplasm Staging (methods)
• Organotechnetium Compounds
• Radiopharmaceuticals
• Reproducibility of Results
• Technetium
• Tomography, Emission-Computed, Single-Photon (methods)