PhD defense of Sandra van der Velden

On Thursday 21 March, Sandra van der Velden will defend her thesis entitled: “Interventional nuclear imaging for radioembolisation guidance.”


The aim of this thesis is to investigate the development and application of a device which can acquire both fluoroscopic and nuclear images in the intervention room for guidance of liver radioembolisation procedures. The efficiency of radioembolisation procedures could be greatly enhanced if results of the 99mTc-MAA pre-treatment procedure would already be available in the intervention room, enabling single-session procedures thanks to direct intrahepatic dose feedback, assessment of extrahepatic depositions and lung shunt estimation. This could be achieved with our newly developed detector.

A dual-layer detector, consisting of a gamma camera with cone-beam collimator (nuclear imaging) positioned behind an x-ray flat panel (fluoroscopic imaging) was proven to be feasible for such simultaneous imaging. Depending on the amount of radioactivity shunting to the lungs, treatment may be altered or abandoned. We showed that this fraction can be estimated with a constant minor error with our hybrid imaging device within a few seconds in an interventional setting. Furthermore, we showed that our device is capable of acquiring liver SPECT scans that yield accurate dosimetric metrics for radioembolisation treatment planning in the intervention room within 10 minutes, without compromising image quality. Consequently, fast interventional SPECT of the liver in the intervention room is feasible.

In conclusion, a detector for simultaneous nuclear and fluoroscopic imaging was developed and evaluated for its usage in the improvement of radioembolisation procedures.