| The significance of bremsstrahlung SPECT/CT after yttrium-90 radioembolization treatment in the prediction of extrahepatic side effects. | |
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MedLine Citation:
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PMID: 21975832 Owner: NLM Status: Publisher |
Abstract/OtherAbstract:
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PURPOSE: Unwanted deposition of (90)Y microspheres in organs other than the liver during radioembolization of liver tumours may cause severe side effects such as duodenal ulcer. The aim of this study was to evaluate the significance of posttherapy bremsstrahlung (BS) SPECT/CT images of the liver in comparison to planar and SPECT images in the prediction of radioembolization-induced extrahepatic side effects. METHODS: A total of 188 radioembolization procedures were performed in 123 patients (50 women, 73 men) over a 2-year period. Planar, whole-body and BS SPECT/CT imaging were performed 24 h after treatment as a part of therapy work-up. Any focally increased extrahepatic accumulation was evaluated as suspicious. Clinical follow-up and gastroduodenoscopy served as reference standards. The studies were reviewed to evaluate whether BS SPECT/CT imaging was of benefit. RESULTS: In the light of anatomic data obtained from SPECT/CT, apparent extrahepatic BS in 43% of planar and in 52% of SPECT images proved to be in the liver and hence false-positive. The results of planar scintigraphy could not be analysed further since 12 images were not assessable due to high scatter artefacts. On the basis of the gastrointestinal (GI) complications and the results of gastroduodenoscopy, true-positive, true-negative, false-positive and false-negative results of BS SPECT and SPECT/CT imaging in the prediction of GI ulcers were determined. The sensitivity, specificity, positive and negative predictive values and the accuracy of SPECT and SPECT/CT in the prediction of GI ulcers were 13%, 88%, 8%, 92% and 82%, and 87%, 100%, 100%, 99% and 99%, respectively. CONCLUSION: Despite the low quality of BS images, BS SPECT/CT can be used as a reliable method to confirm the safe distribution of (90)Y microspheres and in the prediction of GI side effects. |
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Authors:
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Hojjat Ahmadzadehfar; Marianne Muckle; Amir Sabet; Kai Wilhelm; Christiane Kuhl; Kim Biermann; Torjan Haslerud; Hans-Jürgen Biersack; Samer Ezziddin |
Publication Detail:
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Type: JOURNAL ARTICLE Date: 2011-10-6 |
Journal Detail:
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Title: European journal of nuclear medicine and molecular imaging Volume: - ISSN: 1619-7089 ISO Abbreviation: - Publication Date: 2011 Oct |
Date Detail:
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Created Date: 2011-10-6 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 101140988 Medline TA: Eur J Nucl Med Mol Imaging Country: - |
Other Details:
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Languages: ENG Pagination: - Citation Subset: - |
Affiliation:
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Department of Nuclear Medicine, University Hospital Bonn, Sigmund-Freud-Str. 25, 53127, Bonn, Germany, hojjat.ahmadzadehfar@ukb.uni-bonn.de. |
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