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Annals of Nuclear Medicine
Published in: Annals of Nuclear Medicine 9/2014

01-11-2014 | Original Article

Optimized separation of left and right liver lobe in dynamic 99mTc-mebrofenin hepatobiliary scintigraphy using a hybrid SPECT-CT scanner

Authors: Dominik Geisel, Lutz Lüdemann, Bernhard Gebauer, Vera Fröling, Vikas Prasad, Uwe Heimann, Martin Stockmann, Maciej Malinowski, Bernd Hamm, Winfried Brenner, Timm Denecke

Published in: Annals of Nuclear Medicine | Issue 9/2014

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Abstract

Objective

To correctly display the left and right liver lobe separately on dynamic projection scintigraphy, it is essential to adjust the collimator to the angle of the plane between the two liver lobes. We propose an optimized protocol for separating left and right liver lobe in 99mTc-mebrofenin hepatobiliary scintigraphy in a hybrid SPECT-CT device. The protocol uses the inherent attenuation correction low-dose CT (AC-CT) for individually adjusting gamma camera head angulation. The results of this protocol are compared with hypothetical results based on previous MRI, fixed angle, and traditional frontal projection.

Methods

The absolute and relative degrees of overlapping volume between left and right liver lobe parenchyma for frontal projection, 45° right anterior oblique (RAO) projection, RAO angulation based on previously acquired MRI, and RAO based on the AC-CT were measured in 14 patients who underwent 99mTc-mebrofenin hepatobiliary scintigraphy.

Results

Relative degree of overlap was 31.3 ± 15.2 % for frontal projection, 8.2 ± 6.5 % for 45° RAO, 5.5 ± 3.5 % for RAO based on previous MRI, and 3.6 ± 2.5 % for RAO based on AC-CT. The relative overlap of RAO projections based on previous MRI was significantly lower than for frontal projection (p < 0.05). Use of the angle from the prior AC-CT, however, resulted in an even lower degree of overlap (p < 0.05).

Conclusions

Performing 99mTc-mebrofenin hepatobiliary scintigraphy using RAO detector alignment with an angle derived from a prior CT obtained in the SPECT-CT scanner can significantly reduce the degree of overlap between right and left liver lobe. If SPECT-CT is not available, previous CT or MRI or a fixed angle of 45° may be used.
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Metadata
Title
Optimized separation of left and right liver lobe in dynamic 99mTc-mebrofenin hepatobiliary scintigraphy using a hybrid SPECT-CT scanner
Authors
Dominik Geisel
Lutz Lüdemann
Bernhard Gebauer
Vera Fröling
Vikas Prasad
Uwe Heimann
Martin Stockmann
Maciej Malinowski
Bernd Hamm
Winfried Brenner
Timm Denecke
Publication date
01-11-2014
Publisher
Springer Japan
Published in
Annals of Nuclear Medicine / Issue 9/2014
Print ISSN: 0914-7187
Electronic ISSN: 1864-6433
DOI
https://doi.org/10.1007/s12149-014-0883-0

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