Liver Cancer pp 287-301 | Cite as

Perfusion Scintigraphy with Integrated Single Photon Emission Computed Tomography/Computed Tomography in the Management of Transarterial Treatment of Hepatic Malignancies

  • Timm Denecke
  • Bert Hildebrandt
  • Enrique Lopez-Hänninen
Part of the Methods of Cancer Diagnosis, Therapy and Prognosis book series (HAYAT, volume 5)

During the recent years it has been shown that transarterial applications of anticancer agents are promising approaches in the treatment of hepatic malignancies. While new techniques led to a reappraisal of hepatic arterial infusion chemotherapy (HAIC) over implanted port systems, there has also been a growing interest in the use of transarterial radioembolization (RE). The concept of transarterial regional oncologic treatment of hepatic malignancies presupposes that the entire liver can be exclusively treated over the supplying arteries. Several imaging modalities are in use for prediction and control of per-fusion territories of intraarterial catheters. Besides digital subtraction angiography (DSA), computed tomography (CT) and magnetic resonance imaging (MRI), scin-tigraphic imaging is being employed to visualize the intrahepatic perfusion pattern, to exclude extrahepatic perfusion, and to assess an intrahepatic arteriovenous shunting to the lung. In the following, the current status of HAIC and RE in cancer therapy, the application techniques and the use of different imaging modalities, especially single photon emission computed tomography (SPECT) and SPECT with integrated computed tomography (SPECT-CT), for planning and control of treatment will be discussed.

Keywords

Catheter Pancreatitis Oncol Radionuclide Perforation 

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. Amthauer, H., Denecke, T., Rohlfing, T., Ruf, J., Bohmig, M., Gutberlet, M., Plockinger, U., Felix, R., and Lemke, A.J. 2005. Value of image fusion using single photon emission computed tomography with integrated low dose computed tomography in comparison with a retrospective voxel-based method in neuroendocrine tumours. Eur. Radiol. 15: 1456–1462.PubMedCrossRefGoogle Scholar
  2. Andrews, J.C., Walker, S.C., Ackermann, R.J., Cotton, L.A., Ensminger, W.D., and Shapiro, B. 1994. Hepatic radioembolization with yttrium-90 containing glass microspheres: preliminary results and clinical follow-up. J. Nucl. Med. 35: 1637–1644.PubMedGoogle Scholar
  3. Bocher, M., Balan, A., Krausz, Y., Shrem, Y., Lonn, A., Wilk, M., and Chisin, R. 2000. Gamma camera-mounted anatomical X-ray tomography: technology, system characteristics and first images. Eur. J. Nucl. Med. 27: 619–627.PubMedCrossRefGoogle Scholar
  4. Campbell, A.M., Bailey, I.H., and Burton, M.A. 2001. Tumour dosimetry in human liver following hepatic yttrium-90 microsphere therapy. Phys. Med. Biol. 46: 487–498.PubMedCrossRefGoogle Scholar
  5. Cantore, M., Mambrini, A., Fiorentini, G., Rabbi, C., Zamagni, D., Caudana, R., Pennucci, C., Sanguinetti, F., Lombardi, M., and Nicoli, N. 2005. Phase II study of hepatic intraarterial epirubicin and cisplatin, with systemic 5-fluor-ouracil in patients with unresectable biliary tract tumors. Cancer 103: 1402–1407.PubMedCrossRefGoogle Scholar
  6. Cohen, A.D., and Kemeny, N.E. 2003. An update on hepatic arterial infusion chemotherapy for colorectal cancer. Oncologist 8: 553–566.PubMedCrossRefGoogle Scholar
  7. Dancey, J.E., Shepherd, F.A., Paul, K., Sniderman, K.W., Houle, S., Gabrys, J., Hendler, A.L., and Goin, J.E. 2000. Treatment of nonresect-able hepatocellular carcinoma with intra-hepatic 90Y-microspheres. J. Nucl. Med. 41: 1673–1681.PubMedGoogle Scholar
  8. Denecke, T., Hildebrandt, B., Lehmkuhl, L., Peters, N., Nicolaou, A., Pech, M., Riess, H., Ricke, J., Felix, R., and Amthauer, H. 2005. Fusion imaging using a hybrid SPECT-CT camera improves port perfusion scintigraphy for control of hepatic arterial infusion of chemotherapy in colorectal cancer patients. Eur. J. Nucl. Med. Mol. Imaging 32(9): 1003–1010.PubMedCrossRefGoogle Scholar
  9. Gray, B., Van Hazel, G., Hope, M., Burton, M., Moroz, P., Anderson, J., and Gebski, V. 2001. Randomised trial of SIR-Spheres plus chemotherapy vs. chemotherapy alone for treating patients with liver metastases from primary large bowel cancer. Ann. Oncol. 12: 1711–1720.PubMedCrossRefGoogle Scholar
  10. Heinrich, S., Petrowsky, H., Schwinnen, I., Staib-Sebler, E., Gog, C., El-Ganainy, A., Gutt, C., Muller, H.H., and Lorenz, M. 2003. Technical complications of continuous intra-arterial chemotherapy with 5-fluorodeoxyuridine and 5-fluor-ouracil for colorectal liver metastases. Surgery 133: 40–48.PubMedCrossRefGoogle Scholar
  11. Kemeny, N., Huang, Y., Cohen, A.M., Shi, W., Conti, J.A., Brennan, M.F., Bertino, J.R., Turnbull, A.D., Sullivan, D., Stockman, J., Blumgart, L.H., and Fong, Y. 1999. Hepatic arterial infusion of chemotherapy after resection of hepatic metastases from colorectal cancer. N. Engl. J. Med. 341: 2039–2048.PubMedCrossRefGoogle Scholar
  12. Kerr, D.J., McArdle, C.S., Ledermann, J., Taylor, I., Sherlock, D.J., Schlag, P.M., Buckels, J., Mayer, D., Cain, D., and Stephens, R.J. 2003. Medical Research Council's colorectal cancer study group; European Organisation for Research and Treatment of Cancer colorectal cancer study group. Intrahepatic arterial versus intravenous fluor-ouracil and folinic acid for colorectal cancer liver metastases: a multicentre randomised trial. Lancet 361: 368–373.PubMedCrossRefGoogle Scholar
  13. Lehner, K., Reiser, M., Gebhardt, U., Heuck, A., and Schaff, J. 1987. DSA — control of implanted devices for arterial hepatic perfusion. Cardiovasc. Intervent. Radiol. 10: 71–74.PubMedCrossRefGoogle Scholar
  14. Liu, D.M., Salem, R., Bui, J.T., Courtney, A., Barakat, O., Sergie, Z., Atassi, B., Barrett, K., Gowland, P., Oman, B., Lewandowski, R.J., Gates, V.L., Thurston, K.G., and Wong, C.Y. 2005. Angiographic considerations in patients undergoing liver-directed therapy. J. Vasc. Interv. Radiol. 16: 911–935.PubMedGoogle Scholar
  15. Lorenz, M., and Muller, H.H. 2000. Randomized, multicenter trial of fluorouracil plus leucov-orin administered either via hepatic arterial or intravenous infusion versus fluorodeoxyurid-ine administered via hepatic arterial infusion in patients with nonresectable liver metastases from colorectal carcinoma. J. Clin. Oncol. 18: 243–254.PubMedGoogle Scholar
  16. Lubin, E., Cyjon, A., and Neuman, M. 1987. Technetium-99m macroaggregates for the study of the distribution of arterial infusion chemotherapy in the liver. Clin. Nucl. Med. 12: 385–388.PubMedCrossRefGoogle Scholar
  17. Meta-Analysis Group in Cancer (MAGC). 1996. Reappraisal of hepatic arterial infusion in the treatment of nonresectable liver metastases from colorectal cancer. J. Natl. Cancer Inst. 88: 252–258.CrossRefGoogle Scholar
  18. Morimoto, M., Satake, M., Sekiguchi, R., Haruno, M., and Moriyama, N. 1999. Optimal injection protocol for CT evaluation during hepatic arterial infusion chemotherapy. Invest. Radiol. 34: 744–750.PubMedCrossRefGoogle Scholar
  19. Murthy, R., Nunez, R., Szklaruk, J., Erwin, W., Madoff, D.C., Gupta, S., Ahrar, K., Wallace, M.J., Cohen, A., Coldwell, D.M., Kennedy, A.S., and Hicks, M.E. 2005. Yttrium-90 microsphere therapy for hepatic malignancy: devices, indications, technical considerations, and potential complications. Radiographics 25(1): S41–S55.PubMedCrossRefGoogle Scholar
  20. Nelson, R.L., and Freels, S. 2004. A systematic review of hepatic artery chemotherapy after hepatic resection of colorectal cancer metastatic to the liver. Dis. Colon Rectum. 47: 739–745.PubMedCrossRefGoogle Scholar
  21. Pelosi, E., Bar, F., Battista, S., Bello, M., Bucchi, M.C., Alabiso, O., Molino, G., and Bisi, G. 1999. Hepatic arterial infusion chemotherapy for unresectable confined liver metastases: prediction of systemic toxicity with the application of a scintigraphic and pharmacokinetic approach. Cancer Chemother. Pharmacol. 44: 505–510.PubMedCrossRefGoogle Scholar
  22. Ricke, J., Hildebrandt, B., Miersch, A., Nicolaou, A., Warschewske, G., Teichgraber, U., Lopez Hanninen, E., Riess, H., and Felix, R. 2004. Hepatic arterial port systems for treatment of liver metastases: factors affecting patency and adverse events. J. Vasc. Interv. Radiol. 15: 825–833.PubMedGoogle Scholar
  23. Sadahiro, S., Suzuki, T., Ishikawa, K., Yasuda, S., Tajima, T., Makuuchi, H., Saitoh, T., and Murayama, C. 2004. Prophylactic hepatic arterial infusion chemotherapy for the prevention of liver metastasis in patients with colon carcinoma: a randomized control trial. Cancer 100: 590–597.PubMedCrossRefGoogle Scholar
  24. Seki, H., Ozaki, T., Takaki, S., Ooi, H., Oda, J., and Shiina, M. 2003. Using slow-infusion MR arteriography and an implantable port system to assess drug distribution at hepatic arterial infusion chemotherapy. AJR Am. J. Roentgenol. 180: 681–686.PubMedGoogle Scholar
  25. Suzuki, Y., Kobayashi, S., and Yasuda, S. 1991. Application of single-photon emission computed tomography (SPECT) with 99mTc-MAA in evaluation of perfusion patterns during hepatic infusion chemotherapy. Ann. Nucl. Med. 5: 123–126.PubMedCrossRefGoogle Scholar
  26. Tanaka, S., Shimada, M., Shirabe, K., Maehara, S., Harimoto, N., Tsujita, E., Sugimachi, K., and Maehara, Y. 2005. A novel intrahepatic arterial chemotherapy after radical resection for advanced hepatocellular carcinoma. Hepatogastroenterology 52: 862–865.PubMedGoogle Scholar
  27. Van Hazel, G., Blackwell, A., Anderson, J., Price, D., Moroz, P., Bower, G., Cardaci, G., and Gray, B. 2004 Randomised phase 2 trial of SIR-Spheres plus fluorouracil/leucovorin chemotherapy versus fluorouracil/leucovorin chemotherapy alone in advanced colorectal cancer. J. Surg. Oncol. 88: 78–85.PubMedCrossRefGoogle Scholar
  28. Ziessman, H.A., Gyves, J.W., Juni, J.E., Wahl, F.L., Thrall, J.H., Ensminger, W.D., Goldstein, H.A., and Dubiansky, V. 1985. Atlas of hepatic arterial perfusion scintigraphy. Clin. Nucl. Med. 10: 675–681.PubMedCrossRefGoogle Scholar

Copyright information

© Springer Science + Business Media B.V. 2009

Authors and Affiliations

  • Timm Denecke
    • 1
  • Bert Hildebrandt
    • 1
  • Enrique Lopez-Hänninen
    • 1
  1. 1.Campus Virchow-KlinikumCharite-Universitatmedizin Berlin, Klinik fur Strahlenheilkonde und PET Zentrum BerlinBerlinGermany

Personalised recommendations