Nutzen der SPECT-CT bei der Radioembolisation

 

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Zusammenfassung

Der Einsatz hybrider Kamerasysteme zur Durchführung der SPECT-CT im Zusammenhang mit der Radioembolisation führt zu einer Steigerung der Planbarkeit und therapeutischen Sicherheit. Es können jeweils für die prätherapeutische Planungs-(MAA-Scan) und die posttherapeutische Bestätigungsszintigrafie (⁹⁰Y-Bremsstrahlscan) 2 Funktionen unterschieden werden: Die Detektion drohender bzw. erfolgter extrahepatischer Depositionen sowie die Ermittlung simulierter bzw. tatsächlicher Aktivitätsverteilungen im Zielvolumen. Während ein erheblicher Nutzen der MAA-SPECT-CT insbesondere für die erstgenannte Funktion gezeigt wurde, ist der Stellenwert der Bremsstrahl-SPECT-CT noch nicht klar herausgearbeitet. Die Bremsstrahlbildgebung wird sich aber letztlich nur durch die Anwendung der SPECT-CT zu einem brauchbaren Verfahren etablieren können. Zusammenfassend gilt die Verfügbarkeit eines hybriden SPECT-CT für die sichere Therapieplanung und Anwendung optimierter Dosimetrieprotokolle als äußerst wünschenswert.

Abstract

The implementation of hybrid SPECT-CT imaging in the context of radioembolization leads to improved treatment safety. Both the pretherapeutic MAA- and posttherapeutic ⁹⁰Y-Bremsstrahl scan, have 2 objectives: The detection of extrahepatic deposition and the assessment of the activity distribution in the target volume. While the significant benefit of MAA-SPECT-CT has been proven especially for the first objective, the value of Bremsstrahl-SPECT-CT is still under investigation. However, Bremsstrahl imaging will only be established as a valuable tool through the implementation of SPECT-CT. In summary, the availability of SPECT-CT imaging systems will be considered highly desirable for safe treatment planning and the application of optimized dosimetry protocols.

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