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Nuclear Medicine and Molecular Imaging
Erschienen in: Nuclear Medicine and Molecular Imaging 1/2016

01.03.2016 | Original Article

Semi-Quantitative Analysis of Post-Transarterial Radioembolization 90Y Microsphere Positron Emission Tomography Combined with Computed Tomography (PET/CT) Images in Advanced Liver Malignancy: Comparison With 99mTc Macroaggregated Albumin (MAA) Single Photon Emission Computed Tomography (SPECT)

verfasst von: Seunghong Rhee, Sungeun Kim, Jaehyuk Cho, Jukyung Park, Jae Seon Eo, Soyeon Park, Eunsub Lee, Yun Hwan Kim, Jae-Gol Choe

Erschienen in: Nuclear Medicine and Molecular Imaging | Ausgabe 1/2016

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Abstract

Objectives

The purpose of this study is to evaluate the correlation between pretreatment planning technetium-99m (99mTc) macroaggregated albumin (MAA) SPECT images and posttreatment transarterial radioembolization (TARE) yttirum-90 (90Y) PET/CT images by comparing the ratios of tumor-to-normal liver counts.

Methods

Fifty-two patients with advanced hepatic malignancy who underwent 90Y microsphere radioembolization from January 2010 to December 2012 were retrospectively reviewed. Patients had undergone 99mTc MAA intraarterial injection SPECT for a pretreatment evaluation of microsphere distribution and therapy planning. After the administration of 90Y microspheres, the patients underwent posttreatment 90Y PET/CT within 24 h. For semiquantitative analysis, the tumor-to-normal uptake ratios in 90Y PET/CT (TNR-yp) and 99mTc MAA SPECT (TNR-ms) as well as the tumor volumes measured in angiographic CT were obtained and analyzed. The relationship of TNR-yp and TNR-ms was evaluated by Spearman's rank correlation and Wilcoxon's matched pairs test.

Results

In a total of 79 lesions of 52 patients, the distribution of microspheres was well demonstrated in both the SPECT and PET/CT images. A good correlation was observed of between TNR-ms and TNR-yp (rho value = 0.648, p < 0.001). The TNR-yp (median 2.78, interquartile range 2.43) tend to show significantly higher values than TNR-ms (median 2.49, interquartile range of 1.55) (p = 0.012). The TNR-yp showed weak correlation with tumor volume (rho = 0.230, p = 0.041).

Conclusions

The 99mTc MAA SPECT showed a good correlation with 90Y PET/CT in TNR values, suggesting that 99mTc MAA can be used as an adequate pretreatment evaluation method. However, the 99mTc MAA SPECT image consistently shows lower TNR values compared to 90Y PET/CT, which means the possibility of underestimation of tumorous uptake in the partition dosimetry model using 99mTc MAA SPECT. Considering that 99mTc MAA is the only clinically available surrogate marker for distribution of microsphere, we recommend measurement of tumorous uptake using 90Y PET/CT should be included routinely in the posttherapeutic evaluation.
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Metadaten
Titel
Semi-Quantitative Analysis of Post-Transarterial Radioembolization 90Y Microsphere Positron Emission Tomography Combined with Computed Tomography (PET/CT) Images in Advanced Liver Malignancy: Comparison With 99mTc Macroaggregated Albumin (MAA) Single Photon Emission Computed Tomography (SPECT)
verfasst von
Seunghong Rhee
Sungeun Kim
Jaehyuk Cho
Jukyung Park
Jae Seon Eo
Soyeon Park
Eunsub Lee
Yun Hwan Kim
Jae-Gol Choe
Publikationsdatum
01.03.2016
Verlag
Springer Berlin Heidelberg
Erschienen in
Nuclear Medicine and Molecular Imaging / Ausgabe 1/2016
Print ISSN: 1869-3474
Elektronische ISSN: 1869-3482
DOI
https://doi.org/10.1007/s13139-015-0366-9

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