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This Article Services Email this article to a friend Similar articles in this journal Alert me to new issues of the journal Download to citation manager Google Scholar Articles by Young, R. Articles by Cheah, G. PubMed Articles by Young, R. Articles by Cheah, G.

SPECT/CT detection of extrahepatic shunting in radiomicrosphere therapy

¹ Nuclear Medicine, Cleveland Clinic, Cleveland, OH ² Interventional Radiography, Cleveland Clinic, Cleveland, OH

Abstract No. 2023

Objectives: Y-90 radioembolization is an emerging therapy for hepatic tumors. This is a retrospective study on the utility of SPECT/CT in the use of Tc99m-MAA imaging for the detection of extrahepatic shunting of Y-90 microspheres prior to radiomicrosphere therapy. Calculations of lung shunts with Tc99m-MAA and detection of gastrointestinal activity are performed prior to the dosimetry and administration of Y-90 microspheres. Manufactures of the Y-90 radiomicrospheres recommend planar scintigraphy techniques to assess shunting. This study is designed to look at the incremental advantage of SPECT/CT in addition to planar imaging for the detection of gastrointestinal shunting.

Methods: 99 patients (66 male, 33 female) underwent Tc99-MAA imaging prior to radioembolization therapy with Y-90 microspheres. Hepatic angiography and vessel embolization was followed by Tc99m-MAA scintigraphy to detect possible extrahepatic shunting to the lung and gastrointestinal tract. All 99 patients underwent planar imaging followed by SPECT with low dose CT of the abdomen. The ability of planar imaging to detect gastrointestinal shunting was then compared to SPECT/CT.

Results: Out of the 99 patients, gastrointestinal shunting was detected by the use of planar imaging in 9 patients (9.0%) while SPECT/CT detected shunting in 23patients (23.2%). 1 patient was determined to have tumor thrombosis of the hepatic vein (1%) by SPECT/CT alone.

Conclusions: SPECT/CT in addition to planar scintigraphy is beneficial in the detection of gastrointestinal shunting prior to Y-90 radioembolization. Increased detection of gastrointestinal shunts allows for intervention before Y-90 radioembolization reducing the risks of gastrointestinal complications

This Article Services Email this article to a friend Similar articles in this journal Alert me to new issues of the journal Download to citation manager Google Scholar Articles by Young, R. Articles by Cheah, G. PubMed Articles by Young, R. Articles by Cheah, G.