Utility of <sup>99m</sup>Tc-human serum albumin diethylenetriamine pentaacetic acid SPECT for evaluating endoleak after endovascular abdominal aortic aneurysm repair

  • Nakai M
  • Sato H
  • Sato M
 et al. 
  • 10


    Mendeley users who have this article in their library.
  • 3


    Citations of this article.


OBJECTIVE: The purpose of this study was to assess the utility of (99m)Tc-human serum albumin diethylenetriamine pentaacetic acid ((99m)Tc-HSAD) SPECT in the detection of endoleaks after endovascular abdominal aortic aneurysm repair. SUBJECTS AND METHODS: Fifteen patients (11 men, four women) with aneurysm sac expansion of 5 mm or greater after endovascular abdominal aortic aneurysm repair underwent three-phase CT, (99m)Tc-HSAD SPECT, and CT during aortography. Sensitivity calculations for three-phase CT and (99m)Tc-HSAD SPECT were performed with CT during aortography as the reference standard. The volume of each endoleak was measured with CT during aortography. Seven subjects underwent embolization with N-butyl cyanoacrylate (NBCA)-Lipiodol (ethiodized oil, Guerbet and metallic coils. Three-phase CT and (99m)Tc-HSAD SPECT were repeated after embolization to assess their efficacy. RESULTS: Endoleaks were interpreted as perigraft radioisotope accumulation in 12 patients (80.0%) on (99m)Tc-HSAD SPECT images, in 13 patients (86.7%) on three-phase CT images, and in 15 patients (100%) on CT during aortography. The mean endoleak volume visualized with (99m)Tc-HSAD SPECT was 8.37 cm(3) (range, 5.2-15.1 cm(3)), and the volume not visualized was 3.47 cm(3) (2.5-4.6 cm(3)), a statistically significant difference (p = 0.019). In two patients, (99m)Tc-HSAD SPECT depicted endoleaks evident at delayed phase CT during aortography but not at three-phase CT, suggesting they were slow-filling endoleaks. Accumulation of (99m)Tc-HSAD corresponding to endoleaks disappeared after embolization, but CT evaluation of embolization was impeded by artifacts of NBCA-Lipiodol and metallic coils. CONCLUSION: Technetium-99m-labeled HSAD SPECT proved less sensitive than three-phase CT but depicted endoleaks with volumes 5.2 cm(3) or greater as perigraft radioisotope accumulation. Slow-filling endoleaks can be visualized with (99m)Tc-HSAD SPECT, which can be used to evaluate the efficacy of embolization.

Author-supplied keywords

  • <sup>99m</sup>Tc-HSAD
  • Abdominal aortic aneurysm
  • Embolization
  • Endoleak
  • Endovascular abdominal aortic aneurysm repair

Get free article suggestions today

Mendeley saves you time finding and organizing research

Sign up here
Already have an account ?Sign in

Find this document

Get full text


  • Motoki Nakai

  • Hirotatsu Sato

  • Morio Sato

  • Akira Ikoma

  • Tetsuo Sonomura

  • Yoshiharu Nishimura

Cite this document

Choose a citation style from the tabs below

Save time finding and organizing research with Mendeley

Sign up for free