PURPOSE: To compare positron emission tomography/computed tomography (PET/CT) imaging with bremsstrahlung single photon emission computed tomography (SPECT) in patients after yttrium-90 ((90)Y) microsphere radioembolization to assess particle uptake. MATERIALS AND METHODS: This prospective study comprised patients with large (> 5 cm) hepatocellular carcinoma (HCC) or tumor-associated portal vein thrombus (PVT), or both. After radioembolization for HCC, patients underwent bremsstrahlung SPECT/CT and time-of-flight PET/CT imaging of (90)Y without additional tracer administration. Follow-up imaging and toxicity was analyzed. Imaging analyses of PET/CT and bremsstrahlung SPECT/CT were independently performed. RESULTS: There were 13 patients enrolled in the study, including 7 with PVT. Median tumor diameter was 7 cm. PET/CT demonstrated precise localization of (90)Y particles in the liver, with specific patterns of uptake in large tumors. In cases of PVT, PET/CT showed activity within the PVT. When correlated to short-term follow-up imaging, areas of necrosis correlated with regions of uptake seen on PET/CT. Compared with bremsstrahlung imaging, PET/CT demonstrated at least comparable spatial resolution with less scatter. Quantitative uptake in nontreated regions of interest showed significantly reduced scatter with PET/CT versus SPECT/CT (1% vs 14%, P < .001). CONCLUSIONS: Evaluation of (90)Y particle uptake with PET/CT potentially demonstrates high spatial resolution and low scatter compared with bremsstrahlung SPECT/CT. Confirmation of particles within PVT on PET/CT correlates with response on follow-up imaging and may account for the efficacy of radioembolization in patients with PVT.
PURPOSE: To compare positron emission tomography/computed tomography (PET/CT) imaging with bremsstrahlung single photon emission computed tomography (SPECT) in patients after yttrium-90 ((90)Y) microsphere radioembolization to assess particle uptake. MATERIALS AND METHODS: This prospective study comprised patients with large (> 5 cm) hepatocellular carcinoma (HCC) or tumor-associated portal vein thrombus (PVT), or both. After radioembolization for HCC, patients underwent bremsstrahlung SPECT/CT and time-of-flight PET/CT imaging of (90)Y without additional tracer administration. Follow-up imaging and toxicity was analyzed. Imaging analyses of PET/CT and bremsstrahlung SPECT/CT were independently performed. RESULTS: There were 13 patients enrolled in the study, including 7 with PVT. Median tumor diameter was 7 cm. PET/CT demonstrated precise localization of (90)Y particles in the liver, with specific patterns of uptake in large tumors. In cases of PVT, PET/CT showed activity within the PVT. When correlated to short-term follow-up imaging, areas of necrosis correlated with regions of uptake seen on PET/CT. Compared with bremsstrahlung imaging, PET/CT demonstrated at least comparable spatial resolution with less scatter. Quantitative uptake in nontreated regions of interest showed significantly reduced scatter with PET/CT versus SPECT/CT (1% vs 14%, P < .001). CONCLUSIONS: Evaluation of (90)Y particle uptake with PET/CT potentially demonstrates high spatial resolution and low scatter compared with bremsstrahlung SPECT/CT. Confirmation of particles within PVT on PET/CT correlates with response on follow-up imaging and may account for the efficacy of radioembolization in patients with PVT.
Authors: Heying Duan; Mohamed H Khalaf; Valentina Ferri; Lucia Baratto; Shyam M Srinivas; Daniel Y Sze; Andrei Iagaru Journal: Eur J Nucl Med Mol Imaging Date: 2021-01-14 Impact factor: 9.236
Authors: Hugo Levillain; Oreste Bagni; Christophe M Deroose; Arnaud Dieudonné; Silvano Gnesin; Oliver S Grosser; S Cheenu Kappadath; Andrew Kennedy; Nima Kokabi; David M Liu; David C Madoff; Armeen Mahvash; Antonio Martinez de la Cuesta; David C E Ng; Philipp M Paprottka; Cinzia Pettinato; Macarena Rodríguez-Fraile; Riad Salem; Bruno Sangro; Lidia Strigari; Daniel Y Sze; Berlinda J de Wit van der Veen; Patrick Flamen Journal: Eur J Nucl Med Mol Imaging Date: 2021-01-12 Impact factor: 9.236
Authors: Arthur J A T Braat; Julia E Huijbregts; I Quintus Molenaar; Inne H M Borel Rinkes; Maurice A A J van den Bosch; Marnix G E H Lam Journal: Front Oncol Date: 2014-07-30 Impact factor: 6.244
Authors: Alexander S Pasciak; Austin C Bourgeois; J Mark McKinney; Ted T Chang; Dustin R Osborne; Shelley N Acuff; Yong C Bradley Journal: Front Oncol Date: 2014-02-27 Impact factor: 6.244