Details

Autor(en) / Beteiligte

• Padia, Siddharth A., MD
• Alessio, Adam, PhD
• Kwan, Sharon W., MD
• Lewis, David H., MD
• Vaidya, Sandeep, MD
• Minoshima, Satoshi, MD, PhD

Titel

Comparison of Positron Emission Tomography and Bremsstrahlung Imaging to Detect Particle Distribution in Patients Undergoing Yttrium-90 Radioembolization for Large Hepatocellular Carcinomas or Associated Portal Vein Thrombosis

Ist Teil von

• Journal of vascular and interventional radiology, 2013-08, Vol.24 (8), p.1147-1153

Ort / Verlag

United States: Elsevier Inc

Erscheinungsjahr

2013

Link zum Volltext

Quelle

MEDLINE

Beschreibungen/Notizen

• Abstract Purpose To compare positron emission tomography/computed tomography (PET/CT) imaging with bremsstrahlung single photon emission computed tomography (SPECT) in patients after yttrium-90 (90 Y) microsphere radioembolization to assess particle uptake. Materials and Methods This prospective study comprised patients with large (> 5 cm) hepatocellular carcinoma (HCC) or tumor-associated portal vein thrombus (PVT), or both. After radioembolization for HCC, patients underwent bremsstrahlung SPECT/CT and time-of-flight PET/CT imaging of90 Y without additional tracer administration. Follow-up imaging and toxicity was analyzed. Imaging analyses of PET/CT and bremsstrahlung SPECT/CT were independently performed. Results There were 13 patients enrolled in the study, including 7 with PVT. Median tumor diameter was 7 cm. PET/CT demonstrated precise localization of90 Y particles in the liver, with specific patterns of uptake in large tumors. In cases of PVT, PET/CT showed activity within the PVT. When correlated to short-term follow-up imaging, areas of necrosis correlated with regions of uptake seen on PET/CT. Compared with bremsstrahlung imaging, PET/CT demonstrated at least comparable spatial resolution with less scatter. Quantitative uptake in nontreated regions of interest showed significantly reduced scatter with PET/CT versus SPECT/CT (1% vs 14%, P < .001). Conclusions Evaluation of90 Y particle uptake with PET/CT potentially demonstrates high spatial resolution and low scatter compared with bremsstrahlung SPECT/CT. Confirmation of particles within PVT on PET/CT correlates with response on follow-up imaging and may account for the efficacy of radioembolization in patients with PVT.