Optimized separation of left and right liver lobe in dynamic 99mTc-mebrofenin hepatobiliary scintigraphy using a hybrid SPECT-CT scanner

Dominik Geisel, Lutz Lüdemann, Bernhard Gebauer, Vera Fröling, Vikas Prasad, Uwe Heimann, Martin Stockmann, Maciej Malinowski, Bernd Hamm, Winfried Brenner, Timm Denecke

Research output: Contribution to journalArticlepeer-review

2 Scopus citations


Objective: To correctly display the left and right liver lobe separately on dynamic projection scintigraphy, it is essential to adjust the collimator to the angle of the plane between the two liver lobes. We propose an optimized protocol for separating left and right liver lobe in 99mTc-mebrofenin hepatobiliary scintigraphy in a hybrid SPECT-CT device. The protocol uses the inherent attenuation correction low-dose CT (AC-CT) for individually adjusting gamma camera head angulation. The results of this protocol are compared with hypothetical results based on previous MRI, fixed angle, and traditional frontal projection.

Methods: The absolute and relative degrees of overlapping volume between left and right liver lobe parenchyma for frontal projection, 45° right anterior oblique (RAO) projection, RAO angulation based on previously acquired MRI, and RAO based on the AC-CT were measured in 14 patients who underwent 99mTc-mebrofenin hepatobiliary scintigraphy.

Results: Relative degree of overlap was 31.3 ± 15.2 % for frontal projection, 8.2 ± 6.5 % for 45° RAO, 5.5 ± 3.5 % for RAO based on previous MRI, and 3.6 ± 2.5 % for RAO based on AC-CT. The relative overlap of RAO projections based on previous MRI was significantly lower than for frontal projection (p < 0.05). Use of the angle from the prior AC-CT, however, resulted in an even lower degree of overlap (p < 0.05).

Conclusions: Performing 99mTc-mebrofenin hepatobiliary scintigraphy using RAO detector alignment with an angle derived from a prior CT obtained in the SPECT-CT scanner can significantly reduce the degree of overlap between right and left liver lobe. If SPECT-CT is not available, previous CT or MRI or a fixed angle of 45° may be used.

Original languageEnglish
Pages (from-to)897-902
Number of pages6
JournalAnnals of Nuclear Medicine
Issue number9
StatePublished - Nov 19 2014


  • CT
  • Liver function
  • Mebrofenin scintigraphy
  • MRI


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