Comparison of lung shunt fraction and intrahepatic distribution obtained from postoperative 90Y-selective internal radiation therapy and preoperative 99Tc m-MAA images
10.3760/cma.j.cn321828-20240808-00285
- VernacularTitle:90Y－选择性内放射治疗术后与术前 99Tc m－MAA肺分流率及肝内核素分布的对比分析
- Author:
Hongji YOU
1
;
Min XIONG
;
Ao LI
;
Zhaozhong WU
;
Jingmin FENG
;
Licong LIANG
;
Liteng LIN
;
Kangshun ZHU
;
Shengnan JIANG
Author Information
1. 广州医科大学附属第二医院核医学科，广州 510260
- Publication Type:Journal Article
- Keywords:
Liver neoplasms;
Radiotherapy;
Yttrium radioisotopes;
Tomography, emission-computed, single-photon;
Tomography, X-ray computed;
Technetium Tc 99m aggregate
- From:
Chinese Journal of Nuclear Medicine and Molecular Imaging
2025;45(6):330-334
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To compare the lung shunt fraction (LSF) of 90Y imaging after 90Y-selective internal radiation therapy (SIRT) and preoperative 99Tc m-macroaggregated albumin (MAA) imaging in patients with liver malignant tumors, and compare the volume and visual score of intrahepatic distribution of both nucleins on SPECT/CT images. Methods:A total of 91 patients with liver malignant tumors (78 males, 13 females; age (56.7±13.7)years; 99 cases) who underwent 90Y-SIRT in the Second Affiliated Hospital of Guangzhou Medical University from November 2022 to June 2024 were retrospectively collected. All patients underwent preoperative 99Tc m-MAA simulation and postoperative 90Y distribution verification by whole-body planar scintigraphy and hepatic SPECT/CT imaging. ROIs of the liver and lungs under the anterior-posterior position were delineated on the planar scintigraphy and LSF of 99Tc m-MAA and 90Y were calculated. The volume of interest (VOI) was drawn on the SPECT/CT images to calculate the nuclide distribution volume of both 99Tc m-MAA and 90Y within the liver. Wilcoxon signed rank test was used to compare the difference between two groups. In addition, the liver was divided into five lobes, namely left lateral lobe, left medial lobe, caudate lobe, right anterior lobe and right posterior lobe. Visual assessment of 90Y and 99Tc m-MAA radioactive distribution was performed ( 90Y and 99Tc m-MAA uptakes were graded on a scale of 0-3, where 0 indicated no nuclide accumulation and 3 indicated heavy accumulation). Kappa consistency test was used to analyze the scores of the corresponding lobes between two groups. Results:LSF for 99Tc m-MAA was 11.60%(4.27%, 15.03%), and LSF for 90Y was 11.80%(9.70%, 13.30%), without significant difference ( Z=-1.50, P=0.134). The distribution volume of 99Tc m-MAA within the liver was 542.63(204.00, 818.00)ml, which was significantly different from that of 90Y (688.69(287.00, 954.00)ml; Z=-7.37, P<0.001). Kappa values of the score of each lobe between 99Tc m-MAA imaging and 90Y imaging were 0.469-0.740 (all P<0.001). Conclusions:99Tc m-MAA simulation is reliable for assessing LSF for 90Y-SIRT. The distribution volume of 99Tc m-MAA is generally smaller than that of 90Y, but the consistency of the visual score of radioactive distribution is high. Overall, 99Tc m-MAA may well simulate the distribution pattern of 90Y-SIRT.
