Primary Liver Tumor, Metastatic Liver Clinical Trial
Official title:
The Added Value of Hybrid Functional Anatomical Imaging PET-CT and SPECT-CT in Patients Treated With Yttrium-90 SIRT for Liver
Patients cohort is composed of 50 consecutive patients both male and female with hepatic
malignancies, refered to our nuclear medicine department in the process of radioembolization
between January 2010- August 2015. 26 of the patients were examined with Tc99-MAA and
SPECT-CT and 24 patients were examined with Tc99-MAA , SPECT-CT and PET-CT. Our study
protocol was as follows:
1. Collection of anamnestic data
2. Calculation of liver tumor volume with quantification software
3. Evaluation of the liver tumor involvement
4. Evaluation of liver to lung shunt
5. Calculation dose of SIRTEX
6. Y90 imaging
7. Follow Up
The description of the various stages that the patient goes through SIRTex treatment in the
department of nuclear medicine and their roll in the study is as following:
The first stage is dedicated to the evaluation of the patient's illegibility for the
treatment.
1. In Angiography department
2. In Nuclear medicine department assessment of liver-lung shunting (planar images).
Followed by SPECT-CT of the upper abdomen. SPECT with Low dose CT is used to identify a
leak to the stomach, duodenum and mesentery, as well as to assess uptake of Tc-99m-MAA
in tumor lesions. In order to increase SPECT-CT resolution and sensitivity we
co-registrated SPECT-CT with diagnostic CT provided from previous contrast enhanced CT
or PET-CT. In this procedure, the Low dose CT is used as bridge between diagnostic CT
and the functional imaging SPECT.
3. Calculation dose of Sirtex therapy. At this stage the purpose of the study will be to
investigate the added value of SPECT-CT in the estimation of Tc-99m-MAA uptake in tumor
lesions.
The second stage is dedicated to the assessment Y-90-SIRTex uptake in liver tumors and to
exclude extra hepatic leak. Several hours after treatment patients perform SPECT-CT using
Brummshtrullung emission or PET-CT with the peak Zr-90.
At this stage , in our study, we will compare liver lesions uptake of Tc-99m-MAA in the
SPECT-CT to lesions uptake of Y-90 -SIRT SPECT/PET-CT as well as to assess if SPECT-CT
withTc-99m-MAA may be used as a predictor of Y-90-SIRTex uptake in liver lesion. Does
SPECT-CT with Tc-99m-MAA change patient managment.
The third stage of the study is the collection and monitoring of post treatment outcome
data.
;
Observational Model: Case-Only, Time Perspective: Retrospective