title: Liver perfusion imaging in patients with primary and metastatic liver malignancy: prospective comparison between 99mTc-MAA spect and dynamic CT perfusion.
abstract: OBJECTIVE
  To prospectively analyze the correlation between parameters of liver perfusion from technetium99m-macroaggregates of albumin (99mTc-MAA) single photon emission computed tomography (SPECT) with those obtained from dynamic CT perfusion in patients with primary or metastatic liver malignancy.
  
  
  METHODS
  Twenty-five consecutive patients (11 women, 14 men; mean age 60.9 ± 10.8; range: 32-78 years) with primary (n = 5) or metastatic (n = 20) liver malignancy planned to undergo selective internal radiotherapy underwent dynamic contrast-enhanced CT liver perfusion imaging (four-dimensional spiral mode, scan range 14.8 cm, 15 scans, cycle time 3 seconds) and 99m)Tc-MAA SPECT after intraarterial injection of 180 MBq 99mTc-MAA on the same day. Data were evaluated by two blinded and independent readers for the parameters arterial liver perfusion (ALP), portal venous perfusion (PVP), and total liver perfusion (TLP) from CT, and the 99mTc-MAA uptake-ratio of tumors in relation to normal liver parenchyma from SPECT.
  
  
  RESULTS
  Interreader agreements for quantitative perfusion parameters were high for dynamic CT (r = 0.90-0.98, each P < .01) and 99mTc -MAA SPECT (r = 0.91, P < .01). Significant correlation was found between 99mTc-MAA uptake ratio and ALP (r = 0.7, P < .01) in liver tumors. No significant correlation was found between 99mTc-MAA uptake ratio, PVP (r = -0.381, P = .081), and TLP (r = 0.039, P = .862).
  
  
  CONCLUSIONS
  This study indicates that in patients with primary and metastatic liver malignancy, ALP obtained by dynamic CT liver perfusion significantly correlates with the 99mTc-MAA uptake ratio obtained by SPECT.
authors.affiliation: Institute of Diagnostic and Interventional Radiology, University Hospital Zurich, Raemistr. 100, CH-8091 Zurich, Switzerland.
authors.forename: Caecilia S
authors.initials: CS
authors.lastname: Reiner
authors.forename: Robert
authors.initials: R
authors.lastname: Goetti
authors.forename: Irene A
authors.initials: IA
authors.lastname: Burger
authors.forename: Michael A
authors.initials: MA
authors.lastname: Fischer
authors.forename: Thomas
authors.initials: T
authors.lastname: Frauenfelder
authors.forename: Alexander
authors.initials: A
authors.lastname: Knuth
authors.forename: Thomas
authors.initials: T
authors.lastname: Pfammatter
authors.forename: Niklaus
authors.initials: N
authors.lastname: Schaefer
authors.forename: Hatem
authors.initials: H
authors.lastname: Alkadhi
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D008113:Liver Neoplasms / Q000175:diagnosis* / Q000556:secondary*; D008297:Male; D008875:Middle Aged; D055420:Perfusion Imaging / Q000379:methods*; D019275:Radiopharmaceuticals; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D013668:Technetium Tc 99m Aggregated Albumin; D015899:Tomography, Emission-Computed, Single-Photon / Q000379:methods*; D014057:Tomography, X-Ray Computed / Q000379:methods*
chemical_list: D019275:Radiopharmaceuticals; D013668:Technetium Tc 99m Aggregated Albumin