Document Detail


The significance of 99mTc-MAA SPECT/CT liver perfusion imaging in treatment planning for 90Y-microsphere selective internal radiation treatment.
MedLine Citation:
PMID:  20660379     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
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.
Authors:
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:
Type:  Journal Article     Date:  2010-07-21
Journal Detail:
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:
Created Date:  2010-08-03     Completed Date:  2010-09-01     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0217410     Medline TA:  J Nucl Med     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1206-12     Citation Subset:  IM    
Affiliation:
Department of Nuclear Medicine, University Hospital Bonn, Bonn, Germany. Hojjat.ahmadzadehfar@ukb.uni-bonn.de
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MeSH Terms
Descriptor/Qualifier:
Abdomen / 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:
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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