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  • 2021년 04월호
    [Sci Rep.] Diagnostic and prognostic value of 99m Tc-MAA SPECT/CT for treatment planning of 90 Y-resin microsphere radioembolization for hepatocellular carcinoma: comparison with planar image

    서울대병원 / Mai Hong Son, Le Ngoc Ha, 팽진철*

  • 출처
    Sci Rep.
  • 등재일
    2021 Feb 5
  • 저널이슈번호
    11(1):3207. doi: 10.1038/s41598-021-82887-w.
  • 내용

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    Abstract
    99mTc-macroaggregated albumin (MAA) imaging is performed before transarterial radioembolization (TARE), in which SPECT/CT is presumed more precise than planar image. However, additive role of SPECT/CT has not been well established. Thirty-four consecutive hepatocellular carcinoma patients of intermediate and advanced stages who underwent 90Y-microsphere TARE were recruited. On pre-treatment planning scan using 99mTc-MAA, image characteristics and absorbed dose for target tumors calculated by partition model methods were estimated on planar image and SPECT/CT, respectively. The measurements were repeated on post-treatment 90Y PET/CT, as the reference standard. Treatment response was assessed and predictive values of image parameters were analyzed. The image characteristics including heterogeneity, necrosis and thrombosis uptake were better delineated on SPECT/CT than planar scan. The agreement and correlation of TNr between SPECT/CT and PET/CT were stronger than those between planar scan and PET/CT. Tumor dose estimated on 99mTc-MAA SPECT/CT was more effective than planar image for prediction of treatment response, with cutoff value 125 Gy (sensitivity of 86% and specificity of 75%). In conclusion, 99mTc-MAA SPECT/CT is more closely correlated with post-treatment 90Y PET/CT, and is more effective for predicting treatment response than planar scan. SPECT/CT is superior to planar image in simulation before 90Y TARE.

     

     

    Affiliations

    Mai Hong Son #  1 , Le Ngoc Ha #  1 , Mai Hong Bang  2 , Sungwoo Bae  3   4 , Dinh Truong Giang  2 , Nguyen Tien Thinh  2 , Jin Chul Paeng  5
    1 Department of Nuclear Medicine, 108 Military Central Hospital, Hanoi, Vietnam.
    2 Department of Hepato-Pancreato-Biliary disease, 108 Central Military Hospital, Hanoi, Vietnam.
    3 Department of Nuclear Medicine, Seoul National University Hospital, 101 Daehak-ro, Jongno-gu, Seoul, 03080, Korea.
    4 Department of Molecular Medicine and Biopharmaceutical Sciences, Graduate School of Convergence Science and Technology, Seoul National University, Seoul, Korea.
    5 Department of Nuclear Medicine, Seoul National University Hospital, 101 Daehak-ro, Jongno-gu, Seoul, 03080, Korea. paengjc@snu.ac.kr.
    #

  • 편집위원

    90Y-resin microsphere의 radioembolization 의 치료 효과 예측에 99mTc-macroaggregated albumin SPECT/CT 영상이 치료후 PET/CT 영상보다 유용함을 보여준 연구임. radioembolization 을 시행하는 종양 및 소화기 내과, 영상의학 및 핵의학 임상가에게 관심을 끌 연구로 생각됨.

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