Authors: Timm Denecke Ricarda Rühl Bert Hildebrandt Lars Stelter Christian Grieser Heiner Stiepani Michael Werk Pietr Podrabsky Michail Plotkin Holger Amthauer Jens Ricke Enrique Lopez Hänninen
Publish Date: 2008/01/04
Volume: 18, Issue: 5, Pages: 892-902
Abstract
The purpose of the study was to establish a diagnostic approach to the preparation of patients with colorectal liver metastases considered for transarterial radioembolization RE Twentytwo patients sequentially underwent computed tomography CT thorax/abdomen magnetic resonance imaging MRI liver hepatocytespecific contrast positron emission tomography PET/PETCT F18fluorodesoxyglucose and angiography with perfusion scintigraphy planar imaging tomography with integrated CT SPECTCT The algorithm was continued when no contraindication or alternative treatment option was found The impact of each test on the therapy decision and RE management was recorded Patient evaluation using CT revealed contraindications for RE in 4/22 patients 18 Of the remaining 18 patients 2 were excluded and 3 were assigned to locally ablative treatment based on MRI and PET results 28 The remaining 13 patients entered the planning algorithm SPECTCT revealed gastrointestinal tracer accumulations in 4 31 patients SPECT 2 15 making a modified application necessary In five patients 38 planar scintigraphy revealed relevant hepatopulmonary shunting Therapy was finally administered to all 13 patients without therapyrelated pulmonary or gastrointestinal morbidity Each part of the diagnostic algorithm showed a relevant impact on patient management The sequential approach appears to be suitable and keeps the number of unnecessary treatments and therapy risks to a minimum
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