Utility of 99mTc-MAA SPECT/CT for treatment plan of radioembolization using resin microspheres in HCC patients compared with 90Y PET/CT

  • Mai Hong Son 108 Military Central Hospital
  • Nguyen Do Kien 108 Military Central Hospital
  • Nguyen Thi Kim Dung 108 Military Central Hospital
  • Pham Minh Chi 108 Military Central Hospital
  • Nguyen Binh An 108 Military Central Hospital
  • Le Ngoc Ha 108 Military Central Hospital

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Keywords

Hepatocellular carcinoma, treatment planning, radioembolization, 90Y resin microspheres, 99mTc-MAA SPECT/CT, 90Y PET/CT

Tóm tắt

Objective: The purpose of our study is to validate the utility of 90Y PET/CT compared to SPECT/CT simulation in dosimetry and prediction of treatment response. Subject and method: Thirty-four consecutive hepatocellular carcinoma (HCC) patients, intermediate and advanced stage who underwent 90Y resin microsphere transarterial embolization (TARE) were recruited in the study. Lung shunt fraction (LSF), tumor to-normal liver uptake ratio (TNr) and absorbed dose for target tumors were estimated on 99m Tc-MAA SPECT/CT and 90Y PET/CT. The patients were followed up after treatment within 3 months (2.8 ± 0.84 months) on contrast-enhanced CT to assess treatment response using mRECIST criteria. Result: The imaging characteristics including heterogeneity, necrosis and thrombosis uptake were better delineated on PET/CT imaging than SPECT/CT. The agreement and correlation of TNr on PET/CT and SPECT/CT were stronger. Dose delivery to tumor (Dtumor) threshold of 125Gy estimated on 99mTc-MAA SPECT/CT was more accurate than PET/CT for prediction of treatment response after 90Y-radioembolization in HCC patients with sensitivity of 87.5% and specificity of 90%. Conclusion: 99mTc-MAA SPECT/CT is superior to PET/CT to predict treatment response after 90Y resin microsphere treatment.

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Các tài liệu tham khảo

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