UNLABELLED: 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.
UNLABELLED: 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; Markus Möhlenbruch; Amir Sabet; Carsten Meyer; Marianne Muckle; Torjan Haslerud; Kai Wilhelm; Hans Heinz Schild; Hans Jürgen Biersack; Samer Ezziddin Journal: Eur J Nucl Med Mol Imaging Date: 2011-04-15 Impact factor: 9.236
Authors: Mattijs Elschot; Johannes F W Nijsen; Marnix G E H Lam; Maarten L J Smits; Jip F Prince; Max A Viergever; Maurice A A J van den Bosch; Bernard A Zonnenberg; Hugo W A M de Jong Journal: Eur J Nucl Med Mol Imaging Date: 2014-05-13 Impact factor: 9.236
Authors: Hojjat Ahmadzadehfar; Carsten Meyer; Samer Ezziddin; Amir Sabet; Anja Hoff-Meyer; Marianne Muckle; Timur Logvinski; Hans Heinz Schild; Hans Jürgen Biersack; Kai Wilhelm Journal: Eur J Nucl Med Mol Imaging Date: 2012-10-13 Impact factor: 9.236
Authors: Moritz Palmowski; Andreas Goedicke; Andreas Vogg; Götz Christ; Georg Mühlenbruch; Hans J Kaiser; Rolf W Günther; Christiane K Kuhl; Felix M Mottaghy; Florian F Behrendt Journal: Eur Radiol Date: 2013-06-16 Impact factor: 5.315
Authors: Amy R Deipolyi; A John Iafrate; Andrew X Zhu; Emel A Ergul; Suvranu Ganguli; Rahmi Oklu Journal: J Vasc Interv Radiol Date: 2014-07-30 Impact factor: 3.464