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Research ArticleClinical Investigation

The Significance of 99mTc-MAA SPECT/CT Liver Perfusion Imaging in Treatment Planning for 90Y-Microsphere Selective Internal Radiation Treatment

Hojjat Ahmadzadehfar, Amir Sabet, Kim Biermann, Marianne Muckle, Holger Brockmann, Christiane Kuhl, Kai Wilhelm, Hans-Jürgen Biersack and Samer Ezziddin
Journal of Nuclear Medicine August 2010, 51 (8) 1206-1212; DOI: https://doi.org/10.2967/jnumed.109.074559
Hojjat Ahmadzadehfar
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Amir Sabet
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Kim Biermann
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Marianne Muckle
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Holger Brockmann
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Christiane Kuhl
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Kai Wilhelm
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Hans-Jürgen Biersack
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Samer Ezziddin
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  • FIGURE 1.
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    FIGURE 1.

    Duodenal accumulation (arrows) in a patient with colorectal cancer, not definable on planar images: planar scan (A), SPECT/CT coronal view (B), and CT coronal view (C).

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    FIGURE 2.

    Appropriate use of 99mTc-MAA SPECT/CT in treatment planning for SIRT. *In some centers patients receive prophylactic cholecystectomy (29).

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    TABLE 1.

    Seventy-Six Patients with Different Types of Cancer Evaluated for Radioembolization Therapy

    Type of cancerNumber of patients
    Colorectal cancer20
    Neuroendocrine tumors16
    Hepatocellular carcinoma15
    Cholangiocellular carcinoma9
    Breast cancer5
    Pancreatic carcinoma3
    Gastric cancer2
    Lung cancer1
    Ovarian cancer1
    Leiomyosarcoma1
    Ocular melanoma1
    Malignant melanoma1
    Cancer of unknown origin1
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    TABLE 2.

    Sensitivity, Specificity, Positive Predictive Value (PPV), and Negative Predictive Value (NPV) of 99mTc-MAA Planar, SPECT, and SPECT/CT Studies in Retrospective Analysis and RLC

    StudySensitivity (%)Specificity (%)PPV (%)NPV (%)
    Planar32 (18–51)989271
    SPECT41 (25–59)989373
    SPECT/CT100 (87–100); 82% in RLC9389; 88 in RLC100; 90 in RLC
    • Data in parentheses are 95% confidence intervals.

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    TABLE 3.

    Number of Cases in Which Planar Imaging, SPECT, or SPECT/CT Was Successful in Determining Exact Anatomic Location of Extrahepatic Perfusion Abnormalities

    StudyGallbladderStomach*DuodenumIntestine (other than duodenum)SpleenAbdominal wallCoil regionDiaphragm
    Planar01070100
    SPECT11070200
    SPECT/CT9111192361
    • ↵* Four cases were due to free 99mTc in stomach, all in concordance with thyroid gland uptake.

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Journal of Nuclear Medicine: 51 (8)
Journal of Nuclear Medicine
Vol. 51, Issue 8
August 1, 2010
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The Significance of 99mTc-MAA SPECT/CT Liver Perfusion Imaging in Treatment Planning for 90Y-Microsphere Selective Internal Radiation Treatment
Hojjat Ahmadzadehfar, Amir Sabet, Kim Biermann, Marianne Muckle, Holger Brockmann, Christiane Kuhl, Kai Wilhelm, Hans-Jürgen Biersack, Samer Ezziddin
Journal of Nuclear Medicine Aug 2010, 51 (8) 1206-1212; DOI: 10.2967/jnumed.109.074559

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The Significance of 99mTc-MAA SPECT/CT Liver Perfusion Imaging in Treatment Planning for 90Y-Microsphere Selective Internal Radiation Treatment
Hojjat Ahmadzadehfar, Amir Sabet, Kim Biermann, Marianne Muckle, Holger Brockmann, Christiane Kuhl, Kai Wilhelm, Hans-Jürgen Biersack, Samer Ezziddin
Journal of Nuclear Medicine Aug 2010, 51 (8) 1206-1212; DOI: 10.2967/jnumed.109.074559
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Cited By...

  • MIRD Pamphlet No. 29: MIRDy90--A 90Y Research Microsphere Dosimetry Tool
  • Yttrium 90 Radioembolization for Hepatocellular Carcinoma
  • A Prospective Study of Quantitative SPECT/CT for Evaluation of Lung Shunt Fraction Before SIRT of Liver Tumors
  • Pharmacokinetics of 99mTc-MAA- and 99mTc-HSA-Microspheres Used in Preradioembolization Dosimetry: Influence on the Liver-Lung Shunt
  • Intraarterial Hepatic SPECT/CT Imaging Using 99mTc-Macroaggregated Albumin in Preparation for Radioembolization
  • Systematic Evaluation of Tumoral 99mTc-MAA Uptake Using SPECT and SPECT/CT in 502 Patients Before 90Y Radioembolization
  • From the Angio Suite to the {gamma}-Camera: Vascular Mapping and 99mTc-MAA Hepatic Perfusion Imaging Before Liver Radioembolization--A Comprehensive Pictorial Review
  • Image-Guided Personalized Predictive Dosimetry by Artery-Specific SPECT/CT Partition Modeling for Safe and Effective 90Y Radioembolization
  • Radiodosimetric Estimates for Radioembolic Therapy of Liver Tumors: Challenges and Opportunities
  • Clinical Feasibility of Fast 3-Dimensional Dosimetry of the Liver for Treatment Planning of Hepatocellular Carcinoma with 90Y-Microspheres
  • Significance of Oral Administration of Sodium Perchlorate in Planning Liver-Directed Radioembolization
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