Imaging using Tc99m-tetrofosmin for the detection of the recurrence of brain tumour: A comparative study with Tc99m-glucoheptonate
Sukanta Barai, GP Bandopadhayaya, PK Julka, A Malhotra, CS Bal, H Dhanpathi
Departments of Nuclear Medicine, All India Institute of Medical Sciences, New Delhi, India
BACKGROUND: In the past «DQ»blood-brain barrier«DQ» agents such as Tc99m-glucoheptonate were routinely used for the diagnosis of brain tumours. Of late, agents used for studying myocardial perfusion namely, Tc99m-tetrofosmin, Thallium-201, and Tc99m-sestamibi have replaced the «DQ»blood-brain barrier agents«DQ» when imaging is undertaken for the detection of the recurrence of brain tumours. However, the incremental diagnostic information provided by Tc99m-tetrofosmin when compared with a blood brain barrier agent in the diagnosis of recurrent brain tumour has not been evaluated till date.
AIMS: The study was carried out to substantiate whether Tc99m-tetrofosmin provides any incremental diagnostic information not provided by the blood brain barrier agent Tc99m-glucoheptonate.
MATERIAL AND METHODS: Brain SPECT scans were performed using Tc99m-tetrofosmin and Tc99m-glucoheptonate in 126 patients of recurrent brain tumour. Bio-distribution and uptake properties of both the tracers were analysed by measuring relative uptake of both the tracers in tumour compared to background (T/B ratio), nasopharynx (T/N ratio) and scalp (T/S ratio).
STATISTICAL ANALYSIS: Descriptive statistics were calculated for each variable. Pearson«SQ»s correlation coefficient was applied to see agreement of the continuous variables. Paired t test was used to evaluate the difference between two means.
RESULTS: Uptake properties of both the tracers were analysed in 105 patients in whom both Tc99m-tetrofosmin and Tc99m-glucoheptonate showed concentration. The remaining 21 patients in whom the tumour mass did not show Tc99m-tetrofosmin concentration were excluded from the study. Mean T/B ratio, T/N ratio and T/S ratio was 5.83 + 2.09 and 5.99 + 2.26, 0.53 + 0.21 and 0.55 + 0.22 and 1.11 + 0.60 and 1.26 + 0.52 for Tc99m-tetrofosmin and Tc99m-glucoheptonate respectively. No statistically significant difference between T/B ratio and T/N ratio of Tc99m-tetrofosmin and Tc99m-glucoheptonate was found; p values were 0.25 and 0.83 respectively. However there was significant difference (P=0.006) between the T/S ratio of Tc99m-tetrofosmin and that of Tc99m-glucoheptonate.
CONCLUSION: Tc99m-tetrofosmin does not provide any incremental diagnostic information not provided by the blood brain barrier agent Tc99m-glucoheptonate.
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Barai S, Bandopadhayaya G P, Julka P K, Malhotra A, Bal C S, Dhanpathi H. Imaging using Tc99m-tetrofosmin for the detection of the recurrence of brain tumour: A comparative study with Tc99m-glucoheptonate.J Postgrad Med 2004;50:89-93
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Barai S, Bandopadhayaya G P, Julka P K, Malhotra A, Bal C S, Dhanpathi H. Imaging using Tc99m-tetrofosmin for the detection of the recurrence of brain tumour: A comparative study with Tc99m-glucoheptonate. J Postgrad Med [serial online] 2004 [cited 2022 Jan 26 ];50:89-93
Available from: https://www.jpgmonline.com/article.asp?issn=0022-3859;year=2004;volume=50;issue=2;spage=89;epage=93;aulast=Barai;type=0