title: Technical Considerations of Phosphorous-32 Bremsstrahlung SPECT Imaging after Radioembolization of Hepatic Tumors: A Clinical Assessment with a Review of Imaging Parameters.
abstract: Background. Bremsstrahlung (BS) imaging during radioembolization (RE) confirms the deposition of radiotracer in hepatic/extrahepatic tumors. The aim of this study is to demonstrate (32)P images and to optimize the imaging parameters. Materials and Methods. Thirty-nine patients with variable types of hepatic tumors, treated with the intra-arterial injection of (32)P, were included. All patients underwent BS SPECT imaging 24-72 h after tracer administration, using low energy high resolution (LEHR) (18 patients) or medium energy general purpose (MEGP) (21 patients) collimators. A grading scale from 1 to 4 was used to express the compatibility of the (32)P images with those obtained from CT/MRI. Results. Although the image quality obtained with the MEGP collimator was visually and quantitatively better than with the LEHR (76% concordance score versus 71%, resp.), there was no statistically significant difference between them. Conclusion. The MEGP collimator is the first choice for BS SPECT imaging. However, if the collimator change is time consuming (as in a busy center) or an MEGP collimator is not available, the LEHR collimator could be practical with acceptable images, especially in a SPECT study. In addition, BS imaging is a useful method to confirm the proper distribution of radiotherapeutic agents and has good correlation with anatomical findings.
authors.affiliation: Department of Nuclear Medicine, Shohada-e-Tajrish Medical Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
authors.forename: Elahe
authors.initials: E
authors.lastname: Pirayesh
authors.affiliation: Department of Nuclear Medicine, Shohada-e-Tajrish Medical Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
authors.forename: Mahasti
authors.initials: M
authors.lastname: Amoui
authors.affiliation: Department of Interventional Radiology, Noor Medical Imaging Center, Tehran, Iran.
authors.forename: Shahram
authors.initials: S
authors.lastname: Akhlaghpoor
authors.affiliation: Department of Nuclear Sciences, Iranian Atomic Energy Organization, Tehran, Iran.
authors.forename: Shahnaz
authors.initials: S
authors.lastname: Tolooee
authors.affiliation: Department of Nuclear Medicine, Shohada-e-Tajrish Medical Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
authors.forename: Maryam
authors.initials: M
authors.lastname: Khorrami
authors.affiliation: Department of Nuclear Sciences, Iranian Atomic Energy Organization, Tehran, Iran.
authors.forename: Hossain
authors.initials: H
authors.lastname: Poorbeigi
authors.affiliation: Department of Nuclear Sciences, Iranian Atomic Energy Organization, Tehran, Iran.
authors.forename: Shahab
authors.initials: S
authors.lastname: Sheibani
authors.affiliation: The Persian Gulf Nuclear Medicine Research Center, Bushehr University of Medical Sciences, Bushehr, Iran.
authors.forename: Majid
authors.identifier: 0000-0002-2166-3765
authors.initials: M
authors.lastname: Assadi