skip to main content
OSTI.GOV title logo U.S. Department of Energy
Office of Scientific and Technical Information

Title: WE-AB-BRA-05: PET-Guided Delivery Quality Evaluation of Yttrium-90 Microsphere Radioembolizaton for Hepatocellular Carcinoma Patients: The Optimal Sequence of Radioembolizaton and Chemoembolization Treatments

Abstract

Purpose: Selective-internal-radiation-therapy (SIRT) and transarterial-chemoembolization (TACE) are commonly used for treatment of liver tumors. The use of TACE, which is macroembolic, prior to SIRT may cause hemodynamic changes in tumor vasculature that impair yttrium-90 (90Y) microsphere delivery to the targeted lesions. This work aims to quantify dosimetric tumor coverage using 90Y positron emission tomography (PET) dosimetry after SIRT alone compared to TACE followed by SIRT. Methods: A total of 40 consecutive hepatocellular carcinoma (HCC) SIRT patients who had a post-SIRT 90Y PET/CT scan were evaluated. The patient-specific-3D-dose was reconstructed from the PET images. Patients were categorized into two groups: patients received TACE prior SIRT procedure (n=18) and patient received SIRT alone (n=22). The lesions and liver were delineated by a senior radiologist. We evaluated both the lesion-specific dose-volume-histogram (DVH) and the selectivity index (SI) defined as the ratio of the average dose inside the total lesion(s) and the average dose of the normal liver. The SI values of patients were compared based on whether TACE was previously used. Results: A wide spectrum was observed in the lesion-specific DVH-evaluation and SI appeared to be suitable of evaluating the quality of each SIRT infusion. The average SI of the entire patient groupmore » was 3.0, i.e. targeted lesion receiving three times higher dose than normal liver. The average SI was 1.8 for patients who had prior TACE and 3.9 for patients who did not have prior TACE (p=0.008). 85% of the patients with prior TACE demonstrated poor 90Y-microsphere delivery (SI <2) while none demonstrated excellent delivery (SI >4). On the other hand, the incidence SI >4 among patients with no prior TACE was 37%. Conclusion: 3D dose evaluation using post-SIRT PET suggests that 90Y microsphere delivery to liver tumors is impaired among patients who received prior TACE compared to those who receive SIRT alone.« less

Authors:
 [1];  [2]
  1. The University of Texas Southwestern Medical Ctr, Dallas, TX (United States)
  2. University of Maryland School of Medicine, Baltimore, MD (United States)
Publication Date:
OSTI Identifier:
22654095
Resource Type:
Journal Article
Resource Relation:
Journal Name: Medical Physics; Journal Volume: 43; Journal Issue: 6; Other Information: (c) 2016 American Association of Physicists in Medicine; Country of input: International Atomic Energy Agency (IAEA)
Country of Publication:
United States
Language:
English
Subject:
60 APPLIED LIFE SCIENCES; 61 RADIATION PROTECTION AND DOSIMETRY; DELIVERY; HEPATOMAS; IMAGE PROCESSING; LIVER; MICROSPHERES; PATIENTS; POSITRON COMPUTED TOMOGRAPHY; RADIATION DOSES; YTTRIUM 90

Citation Formats

Lin, M, and Saboury, B. WE-AB-BRA-05: PET-Guided Delivery Quality Evaluation of Yttrium-90 Microsphere Radioembolizaton for Hepatocellular Carcinoma Patients: The Optimal Sequence of Radioembolizaton and Chemoembolization Treatments. United States: N. p., 2016. Web. doi:10.1118/1.4957734.
Lin, M, & Saboury, B. WE-AB-BRA-05: PET-Guided Delivery Quality Evaluation of Yttrium-90 Microsphere Radioembolizaton for Hepatocellular Carcinoma Patients: The Optimal Sequence of Radioembolizaton and Chemoembolization Treatments. United States. doi:10.1118/1.4957734.
Lin, M, and Saboury, B. Wed . "WE-AB-BRA-05: PET-Guided Delivery Quality Evaluation of Yttrium-90 Microsphere Radioembolizaton for Hepatocellular Carcinoma Patients: The Optimal Sequence of Radioembolizaton and Chemoembolization Treatments". United States. doi:10.1118/1.4957734.
@article{osti_22654095,
title = {WE-AB-BRA-05: PET-Guided Delivery Quality Evaluation of Yttrium-90 Microsphere Radioembolizaton for Hepatocellular Carcinoma Patients: The Optimal Sequence of Radioembolizaton and Chemoembolization Treatments},
author = {Lin, M and Saboury, B},
abstractNote = {Purpose: Selective-internal-radiation-therapy (SIRT) and transarterial-chemoembolization (TACE) are commonly used for treatment of liver tumors. The use of TACE, which is macroembolic, prior to SIRT may cause hemodynamic changes in tumor vasculature that impair yttrium-90 (90Y) microsphere delivery to the targeted lesions. This work aims to quantify dosimetric tumor coverage using 90Y positron emission tomography (PET) dosimetry after SIRT alone compared to TACE followed by SIRT. Methods: A total of 40 consecutive hepatocellular carcinoma (HCC) SIRT patients who had a post-SIRT 90Y PET/CT scan were evaluated. The patient-specific-3D-dose was reconstructed from the PET images. Patients were categorized into two groups: patients received TACE prior SIRT procedure (n=18) and patient received SIRT alone (n=22). The lesions and liver were delineated by a senior radiologist. We evaluated both the lesion-specific dose-volume-histogram (DVH) and the selectivity index (SI) defined as the ratio of the average dose inside the total lesion(s) and the average dose of the normal liver. The SI values of patients were compared based on whether TACE was previously used. Results: A wide spectrum was observed in the lesion-specific DVH-evaluation and SI appeared to be suitable of evaluating the quality of each SIRT infusion. The average SI of the entire patient group was 3.0, i.e. targeted lesion receiving three times higher dose than normal liver. The average SI was 1.8 for patients who had prior TACE and 3.9 for patients who did not have prior TACE (p=0.008). 85% of the patients with prior TACE demonstrated poor 90Y-microsphere delivery (SI <2) while none demonstrated excellent delivery (SI >4). On the other hand, the incidence SI >4 among patients with no prior TACE was 37%. Conclusion: 3D dose evaluation using post-SIRT PET suggests that 90Y microsphere delivery to liver tumors is impaired among patients who received prior TACE compared to those who receive SIRT alone.},
doi = {10.1118/1.4957734},
journal = {Medical Physics},
number = 6,
volume = 43,
place = {United States},
year = {Wed Jun 15 00:00:00 EDT 2016},
month = {Wed Jun 15 00:00:00 EDT 2016}
}