Geisel Dominik, Lüdemann Lutz, Gebauer Bernhard, Fröling Vera, Prasad Vikas, Heimann Uwe, Stockmann Martin, Malinowski Maciej, Hamm Bernd, Brenner Winfried, Denecke Timm
Klinik für Radiologie, Campus Virchow-Klinikum, Charité, Universitätsmedizin Berlin, Augustenburger Platz 1, 13353, Berlin, Germany,
Ann Nucl Med. 2014 Nov;28(9):897-902. doi: 10.1007/s12149-014-0883-0. Epub 2014 Jul 10.
To correctly display the left and right liver lobe separately on dynamic projection scintigraphy, it is essential to adjust the collimator to the angle of the plane between the two liver lobes. We propose an optimized protocol for separating left and right liver lobe in (99m)Tc-mebrofenin hepatobiliary scintigraphy in a hybrid SPECT-CT device. The protocol uses the inherent attenuation correction low-dose CT (AC-CT) for individually adjusting gamma camera head angulation. The results of this protocol are compared with hypothetical results based on previous MRI, fixed angle, and traditional frontal projection.
The absolute and relative degrees of overlapping volume between left and right liver lobe parenchyma for frontal projection, 45° right anterior oblique (RAO) projection, RAO angulation based on previously acquired MRI, and RAO based on the AC-CT were measured in 14 patients who underwent (99m)Tc-mebrofenin hepatobiliary scintigraphy.
Relative degree of overlap was 31.3 ± 15.2 % for frontal projection, 8.2 ± 6.5 % for 45° RAO, 5.5 ± 3.5 % for RAO based on previous MRI, and 3.6 ± 2.5 % for RAO based on AC-CT. The relative overlap of RAO projections based on previous MRI was significantly lower than for frontal projection (p < 0.05). Use of the angle from the prior AC-CT, however, resulted in an even lower degree of overlap (p < 0.05).
Performing (99m)Tc-mebrofenin hepatobiliary scintigraphy using RAO detector alignment with an angle derived from a prior CT obtained in the SPECT-CT scanner can significantly reduce the degree of overlap between right and left liver lobe. If SPECT-CT is not available, previous CT or MRI or a fixed angle of 45° may be used.
为了在动态投影闪烁扫描中正确地分别显示左右肝叶，必须将准直器调整到两个肝叶之间平面的角度。我们提出了一种在混合单光子发射计算机断层扫描 - 计算机断层扫描（SPECT - CT）设备中进行（99m）锝 - 美罗芬宁肝胆闪烁扫描时分离左右肝叶的优化方案。该方案使用固有衰减校正低剂量计算机断层扫描（AC - CT）来单独调整伽马相机头的角度。将该方案的结果与基于先前磁共振成像（MRI）、固定角度和传统正位投影的假设结果进行比较。
在14例接受（99m）锝 - 美罗芬宁肝胆闪烁扫描的患者中，测量正位投影、45°右前斜位（RAO）投影、基于先前获得的MRI的RAO角度以及基于AC - CT的RAO角度下左右肝叶实质之间重叠体积的绝对和相对度数。
正位投影的相对重叠度为31.3 ± 15.2%，45°RAO为8.2 ± 6.5%，基于先前MRI的RAO为5.5 ± 3.5%，基于AC - CT的RAO为3.6 ± 2.5%。基于先前MRI的RAO投影的相对重叠度显著低于正位投影（p < 0.05）。然而，使用先前AC - CT的角度导致重叠度更低（p <
0.05）。
在SPECT - CT扫描仪中使用基于先前CT获得的角度进行RAO探测器对准来进行（99m）锝 - 美罗芬宁肝胆闪烁扫描，可以显著降低左右肝叶之间的重叠度。如果没有SPECT - CT，可使用先前的CT或MRI或45°的固定角度。
