Grosser Oliver S, Ruf Juri, Kupitz Dennis, Pethe Annette, Ulrich Gerhard, Genseke Philipp, Mohnike Konrad, Pech Maciej, Richter Wolf S, Ricke Jens, Amthauer Holger
Department of Radiology and Nuclear Medicine, University Hospital Magdeburg, Magdeburg, Germany
Department of Radiology and Nuclear Medicine, University Hospital Magdeburg, Magdeburg, Germany Department of Nuclear Medicine, University Hospital Freiburg, Freiburg, Germany.
J Nucl Med. 2016 Jun;57(6):925-7. doi: 10.2967/jnumed.115.169987. Epub 2016 Feb 9.
Perfusion scintigraphy using (99m)Tc-labeled albumin aggregates is mandatory before hepatic radioembolization with (90)Y-microspheres. As part of a prospective trial, the intrahepatic and intrapulmonary stability of 2 albumin compounds, (99m)Tc-MAA (macroaggregated serum albumin [MAA]) and (99m)Tc-HSA (human serum albumin [HSA]), was assessed.
In 24 patients with metastatic colorectal cancer, biodistribution (liver, lung) and liver-lung shunt (LLS) of both tracers (12 patients each) were assessed by sequential planar scintigraphy (1, 5, and 24 h after injection).
Liver uptake of both albumin compounds decreased differently. Although initial LLSs at 1 h after injection were similar in both groups, MAA-LLS increased significantly from 1 (3.9%) to 5 h (7.7%) and 24 h (9.9%) after injection, respectively. HSA-LLS did not change significantly (1 to 5 h), indicating a steady state of pulmonary and intrahepatic degradation.
Compared with (99m)Tc-MAA-microspheres, (99m)Tc-HSA-microspheres are likely more resistant to degradation over time, allowing a reliable LLS determination even at later time points.
在用（90）Y微球进行肝动脉放射性栓塞之前，必须使用（99m）Tc标记的白蛋白聚集体进行灌注闪烁扫描。作为一项前瞻性试验的一部分，评估了两种白蛋白化合物（99m）Tc-MAA（大颗粒聚合血清白蛋白[MAA]）和（99m）Tc-HSA（人血清白蛋白[HSA]）在肝内和肺内的稳定性。
在24例转移性结直肠癌患者中，通过序贯平面闪烁扫描（注射后1、5和24小时）评估了两种示踪剂（每组12例患者）的生物分布（肝脏、肺）和肝肺分流（LLS）。
两种白蛋白化合物在肝脏的摄取下降情况不同。虽然两组在注射后1小时的初始LLS相似，但MAA-LLS在注射后分别从1小时（3.9%）增加到5小时（7.7%）和24小时（9.9%）。HSA-LLS没有显著变化（1至5小时），表明肺和肝内降解处于稳定状态。
与（99m）Tc-MAA微球相比，（99m）Tc-HSA微球随着时间推移可能更耐降解，即使在较晚时间点也能可靠地测定LLS。
