RT Journal Article
SR Electronic
T1 The effectiveness of SPECT/CT in hepatic arterial Tc-99m MAA scan (MAAS) planning prior to hepatic Y-90 microsphere therapy (YT)
JF Journal of Nuclear Medicine
JO J Nucl Med
FD Society of Nuclear Medicine
SP 1663
OP 1663
VO 50
IS supplement 2
A1 Heiba, Sherif
A1 Jiang, Manli
A1 Weintraub, F. S. Nowakowski, P. Stangl, J
A1 Stangl, Anondo
A1 Nowakowski, Scott
A1 Kim, Edward
A1 Knesaurek, Karin
A1 Zhang, Zhuangyu
A1 Machac, Josef
YR 2009
UL http://jnm.snmjournals.org/content/50/supplement_2/1663.abstract
AB 1663 Objectives MAAS is utilized to assess proper infusion catheter positioning & absence of abdominal extrahepatic shunting (ES) prior to YT. To this end, accuracy & certainty of planar & SPECT were compared with SPECT/CT MAAS findings on same patients. Methods 133 MAAS were performed with planar & SPECT/CT prior to YT. Planar, SPECT, & SPECT/CT were separately reviewed by 2 observers for hepatic regional distribution (HRD) pattern (right, left lobes, segmental or all), & presence/location of ES. The confidence in each assessment was categorized as certain or uncertain. Most patients had prior liver therapy (36 partial resection, 74 chemoembolization, & 16 radiation). Results Of 133 SPECT/CT studies, the recognized HRD was less accurate (P< 0.001) in SPECT alone (118) & planar (109). Certainty of HRD was decreased (p< 0.001) in planar (69) & SPECT (102) than SPECT/CT (133). ES was seen in 18 MAAS by SPECT/CT (stomach, duodenum, pancreas, spleen or combinations), of which significantly less correct ES was observed in planar (9) & SPECT alone (13). Certainty of ES was notably less (p< 0.001) in planar (56) & SPECT (76) than SPECT/CT (132). Conclusions SPECT/CT imaging allows correct anatomic identification of intra & extrahepatic MAA distribution & if possible should always be obtained during MAAS performed for YT planning. The markedly higher accuracy & certainty of SPECT/CT findings over planar or SPECT alone in our study may have been magnified by unusual liver configuration due to underlying pathology, tumor &/or prior therapy/resection.