| The significance of 99mTc-MAA SPECT/CT liver perfusion imaging in treatment planning for 90Y-microsphere selective internal radiation treatment. | |
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MedLine Citation:
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PMID: 20660379 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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Selective internal radiation therapy (SIRT), a catheter-based liver-directed modality for treating primary and metastatic liver cancer, requires appropriate planning to maximize its therapeutic response and minimize its side effects. (99m)Tc-macroaggregated albumin (MAA) scanning should precede the therapy to detect any extrahepatic shunting to the lung or gastrointestinal tract. Our aim was to compare the ability of SPECT/CT with that of planar imaging and SPECT in the detection and localization of extrahepatic (99m)Tc-MAA accumulation and to evaluate the impact of SPECT/CT on SIRT treatment planning and its added value to angiography in this setting. METHODS: Ninety diagnostic hepatic angiograms with (99m)Tc-MAA were obtained for 76 patients with different types of cancer. All images were reviewed retrospectively for extrahepatic MAA deposition in the following order: planar, non-attenuation-corrected SPECT, and SPECT/CT. Review of angiograms and follow-up of patients with abdominal shunting served as reference standards. RESULTS: Extrahepatic accumulation was detected by planar imaging, SPECT, and SPECT/CT in 12%, 17%, and 42% of examinations, respectively. The sensitivity for detecting extrahepatic shunting with planar imaging, SPECT, and SPECT/CT was 32%, 41%, and 100%, respectively; specificity was 98%, 98%, and 93%, respectively. The respective positive predictive values were 92%, 93%, and 89%, and the respective negative predictive values were 71%, 73%, and 100%. The therapy plan was changed according to the results of planar imaging, SPECT, and SPECT/CT in 7.8%, 8.9%, and 29% of patients, respectively. CONCLUSION: In pre-SIRT planning, (99m)Tc-MAA SPECT/CT is valuable for identifying extrahepatic visceral sites at risk for postradioembolization complications. |
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Authors:
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Hojjat Ahmadzadehfar; Amir Sabet; Kim Biermann; Marianne Muckle; Holger Brockmann; Christiane Kuhl; Kai Wilhelm; Hans-Jürgen Biersack; Samer Ezziddin |
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Publication Detail:
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Type: Journal Article Date: 2010-07-21 |
Journal Detail:
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Title: Journal of nuclear medicine : official publication, Society of Nuclear Medicine Volume: 51 ISSN: 1535-5667 ISO Abbreviation: J. Nucl. Med. Publication Date: 2010 Aug |
Date Detail:
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Created Date: 2010-08-03 Completed Date: 2010-09-01 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 0217410 Medline TA: J Nucl Med Country: United States |
Other Details:
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Languages: eng Pagination: 1206-12 Citation Subset: IM |
Affiliation:
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Department of Nuclear Medicine, University Hospital Bonn, Bonn, Germany. Hojjat.ahmadzadehfar@ukb.uni-bonn.de |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Abdomen
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radionuclide imaging Adult Aged Aged, 80 and over Data Interpretation, Statistical Embolization, Therapeutic Female Gallbladder / metabolism, radionuclide imaging Humans Image Interpretation, Computer-Assisted Liver / radionuclide imaging* Liver Circulation / physiology* Liver Neoplasms / drug therapy*, radionuclide imaging* Male Microspheres Middle Aged Patient Care Planning Radionuclide Angiography Radiopharmaceuticals / diagnostic use* Reference Standards Technetium Tc 99m Aggregated Albumin / diagnostic use* Tomography, Emission-Computed Tomography, Emission-Computed, Single-Photon Yttrium Radioisotopes / administration & dosage, therapeutic use* |
| Chemical | |
Reg. No./Substance:
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0/Radiopharmaceuticals; 0/Technetium Tc 99m Aggregated Albumin; 0/Yttrium Radioisotopes |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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