RT Journal Article SR Electronic T1 Diagnostic accuracy of Tc-99m Methionine SPECT/CT for recurrent glioma: Comparison with F-18 FDG PET/CT and contrast-enhanced MRI JF Journal of Nuclear Medicine JO J Nucl Med FD Society of Nuclear Medicine SP 1688 OP 1688 VO 59 IS supplement 1 A1 Punit Sharma A1 GEETANJALI Arora A1 Anil Mishra A1 Rakesh Kumar YR 2018 UL http://jnm.snmjournals.org/content/59/supplement_1/1688.abstract AB 1688Objectives: Post-therapy changes in treated glioma patients can’t be reliably differentiated from tumor recurrence. We evaluated the role of Tc-99m Methionine SPECT/CT (Single Photon Emission Computed Tomography/Computed Tomography) in diagnosis of recurrent glioma and compared the same with F-18 FDG PET/CT (Positron Emission Tomography) and contrast-enhanced Magnetic Resonance Imaging (CeMRI). Methods: 44 patients with histologically proven, previously treated glioma and clinical suspicion of recurrence were prospectively enrolled in the study. All patients underwent Tc-99m Methionine SPECT/CT, F-18 FDG PET/CT and CeMRI of brain. Combination of repeat imaging, biopsy and/or clinical follow-up (6-36 months) was taken as reference standard. Sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) and accuracy, with 95% CI, were calculated. Chi-square (χ2) test was used to compare diagnostic values among modalities. Results: Of 44 patients, 5 were lost to follow up, so the final analysis was done with data from 39 patients (28 male; 11 female, Age: 38.05±9.7 years). PPV and NPV for Tc-99m Methionine SPECT/CT, F-18 FDG PET/CT and CeMRI were 95.6% & 56.2%, 92.3% & 61.5% and 79.4% & 42.9%, respectively. Sensitivity and specificity for the three modalities were 75.9% & 90%, 82.8% & 80% and 87.1% & 30%. Specificity of Tc-99m Methionine SPECT/CT was significantly higher than CeMRI (p<0.0001) but not F-18 FDG PET/CT (p 0.36). No significant difference was seen between the modalities for sensitivity and accuracy. Conclusions: Tc-99m Methionine is a promising tracer for evaluating recurrent glioma. Diagnostic values of Tc-99m Methionine SPECT/CT and F-18 FDG PET/CT are similar, so it may be used as a cost-effective alternative. Also, Tc-99m Methionine SPECT/CT is more specific than CeMRI.