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European Journal of Nuclear Medicine and Molecular Imaging

Published in:

01-02-2012 | Original Article

The significance of bremsstrahlung SPECT/CT after yttrium-90 radioembolization treatment in the prediction of extrahepatic side effects

Authors: Hojjat Ahmadzadehfar, Marianne Muckle, Amir Sabet, Kai Wilhelm, Christiane Kuhl, Kim Biermann, Torjan Haslerud, Hans-Jürgen Biersack, Samer Ezziddin

Published in: European Journal of Nuclear Medicine and Molecular Imaging | Issue 2/2012

Abstract

Purpose

Unwanted deposition of ⁹⁰Y microspheres in organs other than the liver during radioembolization of liver tumours may cause severe side effects such as duodenal ulcer. The aim of this study was to evaluate the significance of posttherapy bremsstrahlung (BS) SPECT/CT images of the liver in comparison to planar and SPECT images in the prediction of radioembolization-induced extrahepatic side effects.

Methods

A total of 188 radioembolization procedures were performed in 123 patients (50 women, 73 men) over a 2-year period. Planar, whole-body and BS SPECT/CT imaging were performed 24 h after treatment as a part of therapy work-up. Any focally increased extrahepatic accumulation was evaluated as suspicious. Clinical follow-up and gastroduodenoscopy served as reference standards. The studies were reviewed to evaluate whether BS SPECT/CT imaging was of benefit.

Results

In the light of anatomic data obtained from SPECT/CT, apparent extrahepatic BS in 43% of planar and in 52% of SPECT images proved to be in the liver and hence false-positive. The results of planar scintigraphy could not be analysed further since 12 images were not assessable due to high scatter artefacts. On the basis of the gastrointestinal (GI) complications and the results of gastroduodenoscopy, true-positive, true-negative, false-positive and false-negative results of BS SPECT and SPECT/CT imaging in the prediction of GI ulcers were determined. The sensitivity, specificity, positive and negative predictive values and the accuracy of SPECT and SPECT/CT in the prediction of GI ulcers were 13%, 88%, 8%, 92% and 82%, and 87%, 100%, 100%, 99% and 99%, respectively.

Conclusion

Despite the low quality of BS images, BS SPECT/CT can be used as a reliable method to confirm the safe distribution of ⁹⁰Y microspheres and in the prediction of GI side effects.

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Title: The significance of bremsstrahlung SPECT/CT after yttrium-90 radioembolization treatment in the prediction of extrahepatic side effects
Authors: Hojjat Ahmadzadehfar
Marianne Muckle
Amir Sabet
Kai Wilhelm
Christiane Kuhl
Kim Biermann
Torjan Haslerud
Hans-Jürgen Biersack
Samer Ezziddin
Publication date: 01-02-2012
Publisher: Springer-Verlag
Published in: European Journal of Nuclear Medicine and Molecular Imaging / Issue 2/2012
Print ISSN: 1619-7070
Electronic ISSN: 1619-7089
DOI: https://doi.org/10.1007/s00259-011-1940-8

Keynote webinar | Spotlight on medication adherence

Springer Medicine

The significance of bremsstrahlung SPECT/CT after yttrium-90 radioembolization treatment in the prediction of extrahepatic side effects

Abstract

Purpose

Methods

Results

Conclusion

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusion

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