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The role of SPECT/CT in radioembolization of liver tumours

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Ahmadzadehfar, Hojjat [Department of Nuclear Medicine, University Hospital Bonn, Bonn, Germany] Duan, Heying [Department of Biomedical Imaging und Image-guided Therapy, Clinical Division of Nuclear Medicine, Medical University of Vienna, Vienna, Austria] Haug, Alexander R. [Department of Biomedical Imaging und Image-guided Therapy, Clinical Division of Nuclear Medicine, Medical University of Vienna, Vienna, Austria] Walrand, Stephan [UCL] Hoffmann, Martha [Department of Biomedical Imaging und Image-guided Therapy, Clinical Division of Nuclear Medicine, Medical University of Vienna, Vienna, Austria]

Radioembolization (RE) with 90Y microspheres is a promising catheter-based therapeutic option for patients with unresectable primary and metastatic liver tumours. Its rationale arises from the dual blood supply of liver tissue through the hepatic artery and the portal vein. Metastatic hepatic tumours measuring >3 mm derive 80-100 % of their blood supply from the arterial rather than the portal hepatic circulation. Typically, an angiographic evaluation combined with 99mTc-macroaggregated albumin (99mTc-MAA) scan precedes therapy to map the tumour feeding vessels as well as to avoid the inadvertent deposition of microspheres in organs other than the liver. Prior to administration of 99mTc-M AA, p ro p hylactic coil embolization of the gastroduodenal artery is recommended to avoid extrahepatic deposition of the microspheres. SPECT/CT allows direct correlation of anatomic and functional information in patients with unresectable liver disease. SPECT/CTis recommended to assess intrahepatic distribution as well as extrahepatic gastrointestinal uptake in these patients. Pretherapeutic SPECT/CT is an important component of treatment planning including catheter positioning and dose finding. A post-therapy bremsstrahlung (BS) scan should follow RE to verify the distribution of the administered tracer. BS SPECT/CT imaging enables better localization and definition of intrahepatic and possible extrahepatic sphere distribution and to a certain degree allows posttreatment dosimetry. In this paper we address the usefulness and significance of SPECT/CT in therapy planning and therapy monitoring of RE. © Springer-Verlag Berlin Heidelberg 2014.

Document type Article de périodique (Journal article) – Synthèse de littérature
Access type Accès restreint
Publication date 2014
Language Anglais
Journal information "European Journal of Nuclear Medicine and Molecular Imaging" - Vol. 41, no. SUPPL. 1 (2014)
Peer reviewed yes
Publisher Springer
e-issn 1619-7089
issn 1619-7070
Publication status Publié
Affiliations UCL - (SLuc) Service de médecine nucléaire
UCL - SSS/IREC - Institut de recherche expérimentale et clinique
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Permanent URL http://hdl.handle.net/2078.1/160488