1. Tumor-to-Normal Ratio Relationship between Planning Technetium-99 Macroaggregated Albumin and Posttherapy Yttrium-90 Bremsstrahlung SPECT/CT
- Author
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Zachary L. Bercu, James R. Galt, David Brandon, Alexander Villalobos, Ila Sethi, Nima Kokabi, David M. Schuster, Bernard Cheng, and William Wagstaff
- Subjects
Male ,Carcinoma, Hepatocellular ,Single Photon Emission Computed Tomography Computed Tomography ,Technetium Tc 99m Aggregated Albumin ,030218 nuclear medicine & medical imaging ,Emission computerized tomography ,03 medical and health sciences ,0302 clinical medicine ,Predictive Value of Tests ,Interquartile range ,Albumins ,Technetium-99 ,Carcinoma ,Humans ,Medicine ,Yttrium Radioisotopes ,Radiology, Nuclear Medicine and imaging ,Aged ,Retrospective Studies ,business.industry ,Radiotherapy Planning, Computer-Assisted ,Liver Neoplasms ,Middle Aged ,medicine.disease ,Microspheres ,Tumor Burden ,Treatment Outcome ,030220 oncology & carcinogenesis ,Hepatocellular carcinoma ,Predictive value of tests ,Female ,Macroaggregated albumin ,Glass ,Radiopharmaceuticals ,Cardiology and Cardiovascular Medicine ,business ,Nuclear medicine - Abstract
PURPOSE To quantify the relationship of the tumor-to-normal ratio (TNR) attained from the technetium-99m macroaggregated albumin (MAA) and posttreatment yttrium-90 bremsstrahlung (Y90-Brem) single-photon emission computerized tomography (SPECT)/computer tomography (CT) studies in patients with hepatocellular carcinoma (HCC) treated with glass microspheres. MATERIALS AND METHODS Retrospectively, a total of 190 consecutive patients with HCC who underwent 204 MAA and Y90-Brem SPECT/CT for glass microsphere Y90 radiation segmentectomy (Y90-RS) or lobar treatment (Y90-RLT) between 2013 and 2018 were included. Semi-automated regions-of-interests were drawn around the targeted tumor and nontumoral liver tissue on the SPECT/CT studies. TNR values from MAA and Y90-Brem SPECT/CT were compared using paired t-tests, Pearson correlation, and median with interquartile ranges (IQR). RESULTS The mean TNR for MAA and Y90-Brem SPECT/CT was 2.96 ± 1.86 (median, 2.64; IQR, 2.50) and 2.29 ± 1.10 (median, 2.06; IQR, 1.05), respectively (P < .0001). The mean Y90-RLT TNR was 2.88 ± 1.67 (median, 2.59; IQR, 0.83) and 2.17 ± 0.89 (median, 1.98; IQR, 0.81) for MAA and Y90-Brem SPECT/CT, respectively (P < .0001). The mean Y90-RS TNR was 3.02 ± 2.01 (median, 2.87; IQR, 3.01) and 2.39 ± 1.25 (median, 2.11; IQR, 1.28) for MAA and Y90-Brem SPECT/CT, respectively (P = .0003). TNR attained from MAA and Y90 SPECT/CT studies showed a moderate correlation in a positive linear fashion for the overall (r = 0.54; P < .001), Y90-RLT (r = 0.66, P < .001), and Y90-RS cohorts (r = 0.48, P < .001). CONCLUSIONS The TNR attained from Y90-Brem SPECT/CT is often underestimated, positively correlated, and less variable than that attained from MAA SPECT/CT.
- Published
- 2021