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Nuclear Medicine Procedures for Treatment Evaluation and Administration

  • Javier Arbizu
  • Macarena Rodriguez-Fraile
  • Josep M Martí-Climent
  • Inés Domínguez-Prado
  • Carmen Vigil
Chapter
Part of the Medical Radiology book series (MEDRAD)

Abstract

The 90Yttrium radioembolisation (RE) procedure requires the collaboration of a multidisciplinary team that includes hepatologists, oncologists, interventional radiologists and nuclear medicine specialists working together in close collaboration. To avoid toxicity to the patient, a thorough angiographic evaluation is performed to identify extrahepatic vessels that may feed the tumours (to guarantee efficacy). To mimic the microsphere application during the treatment, angiographic evaluation is accomplished with 99mTechnetium-labelled macroaggregated albumin injection into the vessel of interest, followed by imaging. Both procedures combined are essential to plan the RE therapy, and to detect and eventually occlude every collateral vessel arising from a hepatic artery that may carry microspheres to the gastrointestinal tract or other extrahepatic organs. Moreover, this approach permits the calculation of hepatopulmonary shunting, and tumour and liver tissue targeting. With this information taken together, the treatment is designed and activity is calculated to maximise the dose of radiation delivered to liver tumours while safely preserving the non-tumoural parenchyma.

Keywords

Positron Emission Tomography Single Photon Emission Compute Tomography Planar Scintigraphy Nuclear Medicine Procedure Lung Shunt Fraction 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

Abbreviations

RE

Radioembolisation

90Y RE

90Yttrium-loaded microspheres radioembolisation

GI

Gastrointestinal

99mTc-MAA

99mTechnetium-labelled macroaggregated albumin

SPECT

Single photon emission computed tomography imaging

SPECT/CT

Single photon emission computed tomography imaging combined with X-ray computer tomography

PET

Positron emission tomography

PET/CT

Positron emission tomography combined with X-ray computer tomography

MRI

Magnetic resonance imaging

Bq

Becquerel; unit of radioactivity

OS-EM

Ordered subsets expectation maximisation iterative reconstruction

ROI

Region of interest

LS

Hepatopulmonary or lung shunting

Gy

Grey; units of radiation dose

MIRD

Medical internal radiation dosimetry

T/N

Tumour targeting or tumour-to-non-tumour ratio

5-FU

5 Fluorouracil

BS

Bremsstrahlung

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Copyright information

© Springer-Verlag Berlin Heidelberg  2013

Authors and Affiliations

  • Javier Arbizu
    • 1
  • Macarena Rodriguez-Fraile
    • 1
  • Josep M Martí-Climent
    • 1
  • Inés Domínguez-Prado
    • 1
  • Carmen Vigil
    • 1
  1. 1.Department of Nuclear MedicineClinica Universidad De NavarraPamplonaSpain

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