Blood and urine analyses after radioembolization of liver malignancies with [166Ho]Ho-acetylacetonate-poly(l-lactic acid) microspheres

Bakker, Robbert C.; Roos, Remmert de; Ververs, F. F. T.; Lam, Marnix G. E. H.; Lee, Martijn K. van der; Zonnenberg, Bernard A.; Krijger, Gerard C.

doi:10.1016/j.nucmedbio.2019.03.001

Cited by 7 publications

(9 citation statements)

References 33 publications

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“… 12 The microspheres are delivered in a vial (V-vial) in 2 mL of a resuspension medium, containing Pluronic F-68 (Sigma-Aldrich Chemie BV, The Netherlands) and phosphate buffer. 13 Calibration is done by the manufacturer so that the desired activity of Ho-166 in the V-vial is reached at the time of injection. For the HSD, 2 standard vials of 80 MBq and 170 MBq Ho-166 are delivered, but up to 3 vials with personalized activities not exceeding a total of 250 MBq Ho-166 can be ordered (initial activities).…”

Section: Methodsmentioning

confidence: 99%

Radioembolization With Holmium-166 Polylactic Acid Microspheres: Distribution of Residual Activity in the Delivery Set and Outflow Dynamics During Planning and Treatment Procedures

et al. 2021

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Purpose: To evaluate the microsphere outflow dynamics and residual Ho-166 activity during and after transarterial radioembolization planning and treatment procedures, and to assess the distribution and predilection sites of residual activity in the proprietary delivery set and the microcatheter. Materials and Methods: Fifteen planning and 12 therapeutic radioembolization procedures were performed with poly-l-lactic acid microspheres loaded with Ho-166. The amount and distribution of residual activity was assessed by dose calibrator measurements and SPECT imaging. The activity flow profile from the microcatheter was assessed dynamically. For planning procedures, different injection methods were evaluated in order to attempt to decrease the residual activity. Results: The median residual activities for planning and treatment procedures using standard injection methods were 31.2% (range 17.3%–44.1%) and 4.3% (range 3.5%–6.9%), respectively. Planning residual activities could be decreased significantly with 2 injection methods similar to treatment procedures, to 17.5% and 10.9%, respectively ( P = 0.002). Main predilection sites of residual microspheres were the 3-way stopcock and the outflow needle connector. During treatment procedures, more than 80% of the injected activity is transferred during the first 3 injection cycles. Conclusion: After treatment procedures with holmium-loaded microspheres, mean residual activity in the delivery set is reproducibly low and between reported values for glass and resin microspheres. The majority of microspheres is transferred to the patient during the second and third injection cycle. An estimated residual waste of 3% to 4% may be included in the treatment activity calculation. For planning procedures, a modified injection technique should be used to avoid high residual activities.

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Section: Methodsmentioning

confidence: 99%

Radioembolization With Holmium-166 Polylactic Acid Microspheres: Distribution of Residual Activity in the Delivery Set and Outflow Dynamics During Planning and Treatment Procedures

et al. 2021

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“…This amount was shown to allow an accurate simulation of RE microsphere distribution and to contain an amount of holmium to be visible on MR imaging [12]. The microspheres are delivered in a vial (V-vial) in 2 ml of a resuspension medium, containing Pluronic F-68 (Sigma-Aldrich Chemie B.V., The Netherlands) and phosphate buffer [13]. Calibration is done by the manufacturer so that the desired activity of Ho-166 in the V-vial is reached at the time of injection.…”

Section: Methodsmentioning

confidence: 99%

Radioembolisation with Holmium-166 Polylactic Acid Microspheres: Distribution of Residual Activity and Flow Dynamics During Planning and Treatment Procedures

Freesmeyer

Seifert

Gühne

et al. 2020

Preprint

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Purpose:To evaluate the application dynamics and residual Ho-166 activity during and after transarterial radioembolisation planning and treatment procedures, and to assess the distribution and predilection sites of residual activity in the proprietary delivery set and microcatheter.Methods:16 planning (Holmium Scout Dose, HSD) and 12 therapeutic radioembolisation (RE) procedures were performed with poly-L-lactic acid (PLLA) microspheres loaded with Ho-166. The amount and distribution of residual activity was assessed by dose calibrator measurements and SPECT imaging. For 8 HSD and 5 RE procedures, the dynamic of the microsphere flow were assessed. For HSD procedures, different injection methods were evaluated. Results:The mean residual activities for HSD and RE procedures were 20.5 +/-9.7% (range 7.2-44.1%) and 4.8 +/-1.2% (range 3.5-6.9%), respectively. HSD residual activity could be decreased significantly with injections methods similar to RE procedures, from 31.2 +/-9.6% to 17.7 +/-6.9% and 15.0 +/-6.0% (p=0.005). Main predilection sites of residual microspheres were the 3-way stopcock (HSD) and the outflow needle connector (RE). During RE procedures, >80% of the injected activity is transferred during the first three injection cycles.Conclusion: After treatment procedures with PLLA microspheres, mean residual activity in the delivery set is reproducibly low and between reported values for glass and resin microspheres. The majority of microspheres is transferred to the patient during the second and third injection cycle. An estimated residual waste of 3%-4% may be included in the treatment activity calculation. For planning procedures, a modified injection technique should be used to avoid high residual activities.

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“…The highest total excretion fraction was 0.005% of the injected activity with intestinal excretion being lower than renal excretion [ 21 ]. Bakker et al [ 22 ] , assessing 1-h blood plasma and 24-h urine, found the median percentage of 166 Ho compared to the total amount injected to be 0.19% and 0.32%, respectively.…”

Section: Radiation Safetymentioning

confidence: 99%

Holmium-166 Radioembolization: Current Status and Future Prospective

Stella

Braat

Rooij

et al. 2022

Cardiovasc Intervent Radiol

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Since its first suggestion as possible option for liver radioembolization treatment, the therapeutic isotope holmium-166 (166Ho) caught the experts’ attention due to its imaging possibilities. Being not only a beta, but also a gamma emitter and a lanthanide, 166Ho can be imaged using single-photon emission computed tomography and magnetic resonance imaging, respectively. Another advantage of 166Ho is the possibility to perform the scout and treatment procedure with the same particle. This prospect paves the way to an individualized treatment procedure, gaining more control over dosimetry-based patient selection and treatment planning. In this review, an overview on 166Ho liver radioembolization will be presented. The current clinical workflow, together with the most relevant clinical findings and the future prospective will be provided.

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Blood and urine analyses after radioembolization of liver malignancies with [166Ho]Ho-acetylacetonate-poly(l-lactic acid) microspheres

Cited by 7 publications

References 33 publications

Radioembolization With Holmium-166 Polylactic Acid Microspheres: Distribution of Residual Activity in the Delivery Set and Outflow Dynamics During Planning and Treatment Procedures

Radioembolization With Holmium-166 Polylactic Acid Microspheres: Distribution of Residual Activity in the Delivery Set and Outflow Dynamics During Planning and Treatment Procedures

Radioembolisation with Holmium-166 Polylactic Acid Microspheres: Distribution of Residual Activity and Flow Dynamics During Planning and Treatment Procedures

Holmium-166 Radioembolization: Current Status and Future Prospective

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