Semi-Quantitative Analysis of Post-Transarterial Radioembolization 90Y Microsphere Positron Emission Tomography Combined with Computed Tomography (PET/CT) Images in Advanced Liver Malignancy: Comparison With 99mTc Macroaggregated Albumin (MAA) Single Photon Emission Computed Tomography (SPECT)

Seunghong Rhee, Sungeun Kim, Jaehyuk Cho, Jukyung Park, Jae Seon Eo, Soyeon Park, Eunsub Lee, Yun Hwan Kim, Jae-Gol Choe

Research output: Contribution to journalArticle

6 Citations (Scopus)

Abstract

Objectives: The purpose of this study is to evaluate the correlation between pretreatment planning technetium-99m (99mTc) macroaggregated albumin (MAA) SPECT images and posttreatment transarterial radioembolization (TARE) yttirum-90 (90Y) PET/CT images by comparing the ratios of tumor-to-normal liver counts. Methods: Fifty-two patients with advanced hepatic malignancy who underwent 90Y microsphere radioembolization from January 2010 to December 2012 were retrospectively reviewed. Patients had undergone 99mTc MAA intraarterial injection SPECT for a pretreatment evaluation of microsphere distribution and therapy planning. After the administration of 90Y microspheres, the patients underwent posttreatment 90Y PET/CT within 24 h. For semiquantitative analysis, the tumor-to-normal uptake ratios in 90Y PET/CT (TNR-yp) and 99mTc MAA SPECT (TNR-ms) as well as the tumor volumes measured in angiographic CT were obtained and analyzed. The relationship of TNR-yp and TNR-ms was evaluated by Spearman's rank correlation and Wilcoxon's matched pairs test. Results: In a total of 79 lesions of 52 patients, the distribution of microspheres was well demonstrated in both the SPECT and PET/CT images. A good correlation was observed of between TNR-ms and TNR-yp (rho value = 0.648, p <0.001). The TNR-yp (median 2.78, interquartile range 2.43) tend to show significantly higher values than TNR-ms (median 2.49, interquartile range of 1.55) (p = 0.012). The TNR-yp showed weak correlation with tumor volume (rho = 0.230, p = 0.041). Conclusions: The 99mTc MAA SPECT showed a good correlation with 90Y PET/CT in TNR values, suggesting that 99mTc MAA can be used as an adequate pretreatment evaluation method. However, the 99mTc MAA SPECT image consistently shows lower TNR values compared to 90Y PET/CT, which means the possibility of underestimation of tumorous uptake in the partition dosimetry model using 99mTc MAA SPECT. Considering that 99mTc MAA is the only clinically available surrogate marker for distribution of microsphere, we recommend measurement of tumorous uptake using 90Y PET/CT should be included routinely in the posttherapeutic evaluation.

Original languageEnglish
Pages (from-to)63-69
Number of pages7
JournalNuclear Medicine and Molecular Imaging
Volume50
Issue number1
DOIs
Publication statusPublished - 2016 Mar 1

Fingerprint

Single-Photon Emission-Computed Tomography
Microspheres
Positron-Emission Tomography
Albumins
Tomography
Liver
Neoplasms
Tumor Burden
Intra-Arterial Injections
Technetium
Biomarkers

Keywords

  • Liver malignancy
  • Microsphere
  • PET scan
  • Radioembolization
  • Single-photon emission computerized tomography
  • Tc-99m-MAA
  • Y-90

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging

Cite this

@article{7df86ba389024f32abe8fdd48b5e639e,
title = "Semi-Quantitative Analysis of Post-Transarterial Radioembolization 90Y Microsphere Positron Emission Tomography Combined with Computed Tomography (PET/CT) Images in Advanced Liver Malignancy: Comparison With 99mTc Macroaggregated Albumin (MAA) Single Photon Emission Computed Tomography (SPECT)",
abstract = "Objectives: The purpose of this study is to evaluate the correlation between pretreatment planning technetium-99m (99mTc) macroaggregated albumin (MAA) SPECT images and posttreatment transarterial radioembolization (TARE) yttirum-90 (90Y) PET/CT images by comparing the ratios of tumor-to-normal liver counts. Methods: Fifty-two patients with advanced hepatic malignancy who underwent 90Y microsphere radioembolization from January 2010 to December 2012 were retrospectively reviewed. Patients had undergone 99mTc MAA intraarterial injection SPECT for a pretreatment evaluation of microsphere distribution and therapy planning. After the administration of 90Y microspheres, the patients underwent posttreatment 90Y PET/CT within 24 h. For semiquantitative analysis, the tumor-to-normal uptake ratios in 90Y PET/CT (TNR-yp) and 99mTc MAA SPECT (TNR-ms) as well as the tumor volumes measured in angiographic CT were obtained and analyzed. The relationship of TNR-yp and TNR-ms was evaluated by Spearman's rank correlation and Wilcoxon's matched pairs test. Results: In a total of 79 lesions of 52 patients, the distribution of microspheres was well demonstrated in both the SPECT and PET/CT images. A good correlation was observed of between TNR-ms and TNR-yp (rho value = 0.648, p <0.001). The TNR-yp (median 2.78, interquartile range 2.43) tend to show significantly higher values than TNR-ms (median 2.49, interquartile range of 1.55) (p = 0.012). The TNR-yp showed weak correlation with tumor volume (rho = 0.230, p = 0.041). Conclusions: The 99mTc MAA SPECT showed a good correlation with 90Y PET/CT in TNR values, suggesting that 99mTc MAA can be used as an adequate pretreatment evaluation method. However, the 99mTc MAA SPECT image consistently shows lower TNR values compared to 90Y PET/CT, which means the possibility of underestimation of tumorous uptake in the partition dosimetry model using 99mTc MAA SPECT. Considering that 99mTc MAA is the only clinically available surrogate marker for distribution of microsphere, we recommend measurement of tumorous uptake using 90Y PET/CT should be included routinely in the posttherapeutic evaluation.",
keywords = "Liver malignancy, Microsphere, PET scan, Radioembolization, Single-photon emission computerized tomography, Tc-99m-MAA, Y-90",
author = "Seunghong Rhee and Sungeun Kim and Jaehyuk Cho and Jukyung Park and Eo, {Jae Seon} and Soyeon Park and Eunsub Lee and Kim, {Yun Hwan} and Jae-Gol Choe",
year = "2016",
month = "3",
day = "1",
doi = "10.1007/s13139-015-0366-9",
language = "English",
volume = "50",
pages = "63--69",
journal = "Nuclear Medicine and Molecular Imaging",
issn = "1869-3474",
publisher = "Springer Verlag",
number = "1",

}

TY - JOUR

T1 - Semi-Quantitative Analysis of Post-Transarterial Radioembolization 90Y Microsphere Positron Emission Tomography Combined with Computed Tomography (PET/CT) Images in Advanced Liver Malignancy

T2 - Comparison With 99mTc Macroaggregated Albumin (MAA) Single Photon Emission Computed Tomography (SPECT)

AU - Rhee, Seunghong

AU - Kim, Sungeun

AU - Cho, Jaehyuk

AU - Park, Jukyung

AU - Eo, Jae Seon

AU - Park, Soyeon

AU - Lee, Eunsub

AU - Kim, Yun Hwan

AU - Choe, Jae-Gol

PY - 2016/3/1

Y1 - 2016/3/1

N2 - Objectives: The purpose of this study is to evaluate the correlation between pretreatment planning technetium-99m (99mTc) macroaggregated albumin (MAA) SPECT images and posttreatment transarterial radioembolization (TARE) yttirum-90 (90Y) PET/CT images by comparing the ratios of tumor-to-normal liver counts. Methods: Fifty-two patients with advanced hepatic malignancy who underwent 90Y microsphere radioembolization from January 2010 to December 2012 were retrospectively reviewed. Patients had undergone 99mTc MAA intraarterial injection SPECT for a pretreatment evaluation of microsphere distribution and therapy planning. After the administration of 90Y microspheres, the patients underwent posttreatment 90Y PET/CT within 24 h. For semiquantitative analysis, the tumor-to-normal uptake ratios in 90Y PET/CT (TNR-yp) and 99mTc MAA SPECT (TNR-ms) as well as the tumor volumes measured in angiographic CT were obtained and analyzed. The relationship of TNR-yp and TNR-ms was evaluated by Spearman's rank correlation and Wilcoxon's matched pairs test. Results: In a total of 79 lesions of 52 patients, the distribution of microspheres was well demonstrated in both the SPECT and PET/CT images. A good correlation was observed of between TNR-ms and TNR-yp (rho value = 0.648, p <0.001). The TNR-yp (median 2.78, interquartile range 2.43) tend to show significantly higher values than TNR-ms (median 2.49, interquartile range of 1.55) (p = 0.012). The TNR-yp showed weak correlation with tumor volume (rho = 0.230, p = 0.041). Conclusions: The 99mTc MAA SPECT showed a good correlation with 90Y PET/CT in TNR values, suggesting that 99mTc MAA can be used as an adequate pretreatment evaluation method. However, the 99mTc MAA SPECT image consistently shows lower TNR values compared to 90Y PET/CT, which means the possibility of underestimation of tumorous uptake in the partition dosimetry model using 99mTc MAA SPECT. Considering that 99mTc MAA is the only clinically available surrogate marker for distribution of microsphere, we recommend measurement of tumorous uptake using 90Y PET/CT should be included routinely in the posttherapeutic evaluation.

AB - Objectives: The purpose of this study is to evaluate the correlation between pretreatment planning technetium-99m (99mTc) macroaggregated albumin (MAA) SPECT images and posttreatment transarterial radioembolization (TARE) yttirum-90 (90Y) PET/CT images by comparing the ratios of tumor-to-normal liver counts. Methods: Fifty-two patients with advanced hepatic malignancy who underwent 90Y microsphere radioembolization from January 2010 to December 2012 were retrospectively reviewed. Patients had undergone 99mTc MAA intraarterial injection SPECT for a pretreatment evaluation of microsphere distribution and therapy planning. After the administration of 90Y microspheres, the patients underwent posttreatment 90Y PET/CT within 24 h. For semiquantitative analysis, the tumor-to-normal uptake ratios in 90Y PET/CT (TNR-yp) and 99mTc MAA SPECT (TNR-ms) as well as the tumor volumes measured in angiographic CT were obtained and analyzed. The relationship of TNR-yp and TNR-ms was evaluated by Spearman's rank correlation and Wilcoxon's matched pairs test. Results: In a total of 79 lesions of 52 patients, the distribution of microspheres was well demonstrated in both the SPECT and PET/CT images. A good correlation was observed of between TNR-ms and TNR-yp (rho value = 0.648, p <0.001). The TNR-yp (median 2.78, interquartile range 2.43) tend to show significantly higher values than TNR-ms (median 2.49, interquartile range of 1.55) (p = 0.012). The TNR-yp showed weak correlation with tumor volume (rho = 0.230, p = 0.041). Conclusions: The 99mTc MAA SPECT showed a good correlation with 90Y PET/CT in TNR values, suggesting that 99mTc MAA can be used as an adequate pretreatment evaluation method. However, the 99mTc MAA SPECT image consistently shows lower TNR values compared to 90Y PET/CT, which means the possibility of underestimation of tumorous uptake in the partition dosimetry model using 99mTc MAA SPECT. Considering that 99mTc MAA is the only clinically available surrogate marker for distribution of microsphere, we recommend measurement of tumorous uptake using 90Y PET/CT should be included routinely in the posttherapeutic evaluation.

KW - Liver malignancy

KW - Microsphere

KW - PET scan

KW - Radioembolization

KW - Single-photon emission computerized tomography

KW - Tc-99m-MAA

KW - Y-90

UR - http://www.scopus.com/inward/record.url?scp=84959533165&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84959533165&partnerID=8YFLogxK

U2 - 10.1007/s13139-015-0366-9

DO - 10.1007/s13139-015-0366-9

M3 - Article

AN - SCOPUS:84959533165

VL - 50

SP - 63

EP - 69

JO - Nuclear Medicine and Molecular Imaging

JF - Nuclear Medicine and Molecular Imaging

SN - 1869-3474

IS - 1

ER -