Abstract：
Background: Amino acid positron emission tomography (PET) imaging plays a significant role in the diagnosis of gliomas and in differentiating tumor recurrence from necrosis. In this study, the authors evaluated the diagnostic efficacy of [99mTc]Tc-methionine single-photon emission computed tomography-computed tomography (SPECT-CT) in comparison with [11C]methionine PET-magnetic resonance imaging (MRI) in delineating tumors. Methods: Thirty-one (primary: 16 and postoperative: 15) patients of confirmed (either MRI or histopathological proven) glioma underwent both [99mTc]Tc-methionine SPECT-CT and [11C]methionine PET-MRI. A comparative analysis was performed between SPECT, PET, and MR images to calculate the concordance between the modalities and to evaluate the diagnostic efficacy of the [99mTc]Tc-methionine SPECT. Results: [99mTc]Tc-methionine SPECT showed comparable uptake in the tumor lesions in comparison to [11C]methionine PET. A significant and strong positive correlation was observed between the volume of tumor (Vt) in PET and Vt MR (p < 0.004). Likewise, a significant and strong positive correlation was found between Vt SPECT and Vt MR. [99mTc]-methionine has a sensitivity and specificity of 91% and 75%, respectively, compared with 82% and 100% for [11C]methionine in postoperative cases to differentiate the tumor recurrence from necrosis. The sensitivity and specificity of [99mTc]Tc-methionine was 92% and 100%, respectively, compared with 92% and 67% for [11C]methionine in primary tumors. Conclusion: [99mTc]Tc-methionine SPECT-CT is as equally good as [11C]methionine for diagnosing and differentiating it from necrosis especially in high-grade glioma.
摘要：
背景：氨基酸正电子发射断层扫描（PET）成像在胶质瘤的诊断和区分肿瘤复发与坏死中起着重要作用。在这项研究中,作者评估了[99mTc]Tc-蛋氨酸单光子发射计算机断层扫描-计算机断层扫描(SPECT-CT)与[11C]蛋氨酸PET-磁共振成像(MRI)在描绘肿瘤方面的诊断效能.方法：31例（原发性：16例，术后：15例）确诊（MRI或组织病理学证实）胶质瘤患者接受了[99mTc]Tc-蛋氨酸SPECT-CT和[11C]蛋氨酸PET-MRI。对SPECT、PET,和MR图像来计算模态之间的一致性并评估[99mTc]Tc-蛋氨酸SPECT的诊断功效。结果：与[11C]蛋氨酸PET相比，[99mTc]Tc-蛋氨酸SPECT在肿瘤病变中显示出可比的摄取。在PET和VtMR中的肿瘤体积（Vt）之间观察到显着且强的正相关（p<0.004）。同样，在VtSPECT和VtMR之间发现了显着且强的正相关。[99mTc]-蛋氨酸的敏感性和特异性分别为91%和75%,分别,与[11C]蛋氨酸的82％和100％相比，在术后病例中区分肿瘤复发和坏死。[99mTc]Tc-蛋氨酸的敏感性和特异性分别为92%和100%,分别,与原发性肿瘤中[11C]蛋氨酸的92%和67%相比。结论：[99mTc]Tc-蛋氨酸SPECT-CT与[11C]蛋氨酸一样，对诊断和鉴别坏死，尤其是在高级别胶质瘤中。
