Effectiveness of quantitative MAA SPECT/CT for the definition of vascularized hepatic volume and dosimetric approach: phantom validation and clinical preliminary results in patients with complex hepatic vascularization treated with yttrium-90-labeled microspheres
Effectiveness of quantitative MAA SPECT/CT for the definition of vascularized hepatic volume and dosimetric approach: phantom validation and clinical preliminary results in patients with complex hepatic vascularization treated with yttrium-90-labeled microspheres
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DOI：
10.1097/mnm.0b013e32834a716b
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发表时间：
2011-12-01
影响因子：
1.5
通讯作者：
Boucher, Eveline
中科院分区：
文献类型：
--
作者：
Garin, Etienne;Lenoir, Laurence;Boucher, Eveline
本研究的目的是评估在使用钇-90-放射性标记微球（TheraSphere）时，定量单光子发射计算机断层扫描/计算机断层扫描（SPECT/CT）分析在血管化体积测量中的应用。进行体模研究以确认SPECT/CT体积测量。使用SPECT/CT定量分析来测量白蛋白大聚集体（MAA;即，肝脏和肿瘤中的血管化体积），以及肝脏和肿瘤中包含的总活性，这四名连续患者表现出复杂的肝脏血管化，被转诊接受TheraSphere治疗。SPECT/CT容积测量被证明是准确的（平均误差< 7%）和可重复的（观察者间一致性0.99）。对于八次治疗，在复杂的肝脏血管化情况下，与SPECT/CT分析相比，基于血管造影和CT的肝脏体积导致血管化肝脏体积相对高估或低估43.2 +/- 32.7%（5-87%）。根据SPECT/CT数据而不是血管造影和CT数据计算的血管化肝脏体积导致修改了八次治疗中的三次治疗的注射活性。此外，SPECT/CT的定量分析使我们能够计算肿瘤和健康肝脏中的吸收剂量，从而使八次治疗的注射活性加倍。MAA SPECT/CT可准确测量体积。它为复杂肝血管化患者的治疗计划提供了有价值的贡献，特别是用于计算血管化肝脏体积、待注射的活性和吸收剂量。应进行研究以评估定量MAA/SPECT CT在治疗计划中的作用。Nucl Med Commun 32：1245-1255（C）2011 Wolters Kluwer Health垂直栏Lippincott威廉姆斯& Wilkins。核医学通讯2011，32：1245-1255
The goal of this study was to assess the use of quantitative single-photon emission computed tomography/computed tomography (SPECT/CT) analysis for vascularized volume measurements in the use of the yttrium-90-radiolabeled microspheres (TheraSphere). A phantom study was conducted for the validation of SPECT/CT volume measurement. SPECT/CT quantitative analysis was used for the measurement of the volume of distribution of the albumin macroaggregates (MAA; i.e., the vascularized volume) in the liver and the tumor, and the total activity contained in the liver and the tumor in four consecutive patients presenting with a complex liver vascularization referred for a treatment with TheraSphere. SPECT/CT volume measurement proved to be accurate (mean error < 7%) and reproducible (interobserver concordance 0.99). For eight treatments, in cases of complex hepatic vascularization, the hepatic volumes based on angiography and CT led to a relative overestimation or underestimation of the vascularized hepatic volume by 43.2 +/- 32.7% (5-87%) compared with SPECT/CT analyses. The vascularized liver volume taken into account calculated from SPECT/CT data, instead of angiography and CT data, results in modifying the activity injected for three treatments of eight. Moreover, quantitative analysis of SPECT/CT allows us to calculate the absorbed dose in the tumor and in the healthy liver, leading to doubling of the injected activity for one treatment of eight. MAA SPECT/CT is accurate for volume measurements. It provides a valuable contribution to the therapeutic planning of patients presenting with complex hepatic vascularization, in particular for calculating the vascularized liver volume, the activity to be injected and the absorbed doses. Studies should be conducted to assess the role of quantitative MAA/SPECT CT in therapeutic planning. Nucl Med Commun 32: 1245-1255 (C) 2011 Wolters Kluwer Health vertical bar Lippincott Williams & Wilkins. Nuclear Medicine Communications 2011, 32: 1245-1255