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Radiology Research and Practice
Volume 2014, Article ID 407158, 7 pages
Research Article

Technical Considerations of Phosphorous-32 Bremsstrahlung SPECT Imaging after Radioembolization of Hepatic Tumors: A Clinical Assessment with a Review of Imaging Parameters

1Department of Nuclear Medicine, Shohada-e-Tajrish Medical Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
2Department of Interventional Radiology, Noor Medical Imaging Center, Tehran, Iran
3Department of Nuclear Sciences, Iranian Atomic Energy Organization, Tehran, Iran
4The Persian Gulf Nuclear Medicine Research Center, Bushehr University of Medical Sciences, Bushehr, Iran

Received 10 December 2013; Revised 15 February 2014; Accepted 19 February 2014; Published 27 March 2014

Academic Editor: David Maintz

Copyright © 2014 Elahe Pirayesh et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


Background. Bremsstrahlung (BS) imaging during radioembolization (RE) confirms the deposition of radiotracer in hepatic/extrahepatic tumors. The aim of this study is to demonstrate 32P 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 32P, 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 32P 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.