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13N-Ammonia PET/CT for detection of recurrent glioma: a prospective comparison with contrast-enhanced MRI.

Abstract：

PURPOSE:We assessed the value of N-ammonia PET-computed tomography (PET/CT) in recurrent glioma and compared the results with those of contrast-enhanced MRI (CE MRI). MATERIALS AND METHODS:Fifty-two (mean age, 39.8±11.6 years; male, 33; female, 19) histopathologically proven and previously treated glioma patients with clinical suspicion of recurrence were evaluated with 13N-ammonia PET/CT and CE MRI. PET/CT images were evaluated qualitatively and quantitatively (maximum standardized uptake value). Tumour to white matter (T/W), tumour to grey matter (T/G) and tumour to pituitary (T/P) ratios were calculated and cutoff levels were derived with receiver operating characteristic curve analysis. Sensitivity, specificity and predictive values were compared. A combination of clinical follow-up, repeat imaging and biopsy (when available) was taken as the reference standard. RESULTS:On the basis of the reference standard, 23 out of 52 patients were seen to have recurrence. Overall sensitivity, specificity, positive predictive value, negative predictive value and accuracy of 13N-ammonia PET/CT were 82.6, 86.2, 82.6, 86.2 and 84.6%, respectively, whereas those of CE MRI were 96.7, 48.3, 59.5, 93.3 and 69.2%, respectively. Overall, 13N-ammonia PET/CT was statistically superior to CE MRI (P=0.001). In low-grade tumours, 13N-ammonia PET/CT performed better than MRI with an accuracy of 86.8 versus 68.4% (P=0.003). In high-grade tumours, both the modalities had comparable performances with accuracies of 78.6% for N-ammonia PET/CT and 71.4% for CE MRI (P=0.250). Among the ratios, T/P was the most useful, with the largest area under the curve (0.825; P=0.0001). CONCLUSION:N-Ammonia PET/CT shows higher accuracy compared with contrast-enhanced MRI for detecting recurrent gliomas, particularly in low-grade tumours.

journal_name

Nucl Med Commun

journal_title

Nuclear medicine communications

authors

Khangembam BC,Sharma P,Karunanithi S,Singhal A,Das CJ,Kumar P,Julka PK,Bandopadhyaya GP,Kumar R,Malhotra A,Bal C

doi

10.1097/MNM.0b013e328365bb41

subject

Has Abstract

pub_date

2013-11-01 00:00:00

pages

1046-54

issue

eissn

0143-3636

issn

1473-5628

journal_volume

pub_type

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13N-Ammonia PET/CT for detection of recurrent glioma: a prospective comparison with contrast-enhanced MRI.