Semi-Quantitative Analysis of Post-Transarterial Radioembolization 90Y Microsphere Positron Emission Tomography Combined with Computed Tomography (PET/CT) Images in Advanced Liver Malignancy: Comparison With 99mTc Macroaggregated Albumin (MAA) Single Photon Emission Computed Tomography (SPECT)

Rhee, Seunghong; Kim, Sungeun; Cho, Jaehyuk; Park, Jukyung; Eo, Jae Seon; Park, Soyeon; Lee, Eunsub; Kim, Yun Hwan; Choe, Jae Gol

doi:10.1007/s13139-015-0366-9

Cited by 20 publications

(8 citation statements)

References 32 publications

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“…They were mainly carried out in patients with metastatic disease using either resin microspheres [ 28 , 32 , 33 , 34 ], which were biased by several technological issues as catheter repositioning [ 32 , 33 , 34 ] or the absence of spasm evaluation [ 25 , 28 , 32 , 33 , 34 ]. On the other hand, more and more studies have confirmed MAA as a microsphere surrogate, at least in HCC, regardless of microspheres used, even if for some individual cases discrepancies are present [ 27 , 35 , 36 , 37 , 38 , 39 , 40 ].…”

Section: Maa As a Surrogate Of Microspheresmentioning

confidence: 99%

Personalised Dosimetry in Radioembolisation for HCC: Impact on Clinical Outcome and on Trial Design

Garin¹,

Palard

Rolland

2020

Cancers

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Selective internal radiation therapy (SIRT) of hepatocellular carcinoma (HCC) has been used for many years, usually without any specific dosimetry endpoint. Despite good clinical results in early phase studies or in cohort studies, three randomized trials in locally advanced HCC available failed to demonstrate any improvement of overall overall survival (OS) in comparison with sorafenib. In recent years, many studies have evaluated the dosimetry of SIRT using either a simulation-based dosimetry (macroaggregated albumin (MAA)-based) or a post-therapy-based one (90Y-based). The goal of this review is to present the dosimetry concept, tools available, its limitations, and main clinical results described for HCC patients treated with 90Y-loaded resin or glass microspheres. With MAA-based dosimetry, the threshold tumor doses allowing for a response were between 100 and 210 Gy for resin microspheres and between 205 and 257 Gy for glass microspheres. The significant impact of the tumor dose on OS was reported with both devices. The correlation between 90Y-based dosimetry and response was also reported. Regarding the safety, preliminary results are available for both products but with a larger range of normal liver doses values correlated with liver toxicities due to numerous confounding factors. Based on those results, international expert group recommendations for personalized dosimetry have been provided for both devices. The clinical impact of personalized dosimetry has been recently confirmed in a multicenter randomized study demonstrating a doubling of the response rate and an OS of 150% while using personalized dosimetry. Even if technical dosimetry improvements are still under investigation, the use of personalized dosimetry has to be generalized for both clinical practice and trial design.

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Section: Maa As a Surrogate Of Microspheresmentioning

confidence: 99%

Personalised Dosimetry in Radioembolisation for HCC: Impact on Clinical Outcome and on Trial Design

Garin¹,

Palard

Rolland

2020

Cancers

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“…For quantitative analysis, the target/nontarget (T/NT) ratio calculated from counts of their regions of interest (ROI) was widely used in SPECT modality, which was known as the semiquantitative analysis [1, 2]. Positron emission tomography (PET) was regarded as the only modality capable of absolute quantitative analysis in the past [3–5]. However, recently, owing to the development and application of a series of techniques including iterative reconstruction, scatter correction, CT attenuation correction, and resolution recovery, SPECT is also provided with the ability of absolute quantitation [6, 7].…”

Section: Introductionmentioning

confidence: 99%

Standardized Uptake Value Using Thyroid Quantitative SPECT/CT for the Diagnosis and Evaluation of Graves’ Disease: A Prospective Multicenter Study

Dong

Bian

et al. 2019

BioMed Research International

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The clinical applications of the quantitative single photon emission computed tomography (SPECT)/computed tomography (CT) are being expanded to a variety of fields of nuclear medicine. However, clinical application of quantitative SPECT/CT for the evaluation of Graves’ disease (GD) still needs further investigation. Our aim was to investigate the feasibility of standard uptake value (SUV) of the thyroid for the clinical diagnosis and evaluation of GD. In this prospective multicenter study, 116 patients diagnosed with GD (Graves group) and 74 healthy volunteers (control group) were enrolled from 8 different hospitals. All patients underwent technetium pertechnetate (TcO99m4-) SPECT/CT imaging with Q.Metrix quantitative software and 24-hour thyroid radioactive iodine uptake (24h-RAIU) test. The SUVmax and SUVmean in Graves group were significantly higher than those of control group (P<0.01). Cut-off values of SUVmax and SUVmean to predict GD were 231.425 and 116.66 by ROC curves, respectively. The SUVmax and SUVmean in Graves patients were significantly related to serum thyroxine level with correlation coefficient of 0.493 and 0.512 for FT3 and 0.449 and 0.464 for FT4, respectively (all P<0.01). Additionally, the SUVmax and SUVmean in GD positively correlated with 24h-RAIU with a coefficient of 0.832 and 0.830, respectively (P<0.01). The volumes determined by Q.Metrix (35.65 ± 20.56ml) of 72 subjects also positively correlated with that from ultrasound (36.67 ± 21.00ml) with a coefficient of 0.927 (P<0.01). SUV measurements derived from thyroid SPECT/CT may be useful for the clinical diagnosis and evaluation of GD.

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“…A good correlation of predictive MAA SPECT-based dosimetry with post-radioembolization Y-90 PET dosimetry was demonstrated in [ 15 ]. Also, [ 16 ] showed a good correlation of MAA SPECT and Y-90 PET tumor-to-normal uptake ratios. Gnesin et al [ 17 ] showed that the MAA SPECT provides a good estimate of absorbed doses compared to post-treatment PET for tumor and non-tumor tissues in HCC radioembolization.…”

Section: Discussionmentioning

confidence: 99%

Predictive SIRT dosimetry based on a territorial model

et al. 2017

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BackgroundIn the planning of selective internal radiation therapy (SIRT) for liver cancer treatment, one major aspect is to determine the prescribed activity and to estimate the resulting absorbed dose inside normal liver and tumor tissue. An optimized partition model for SIRT dosimetry based on arterial liver territories is proposed. This model is dedicated to characterize the variability of dose within the whole liver. For an arbitrary partition, the generalized absorbed dose is derived from the classical partition model. This enables to consider normal liver partitions for each arterial perfusion supply area and one partition for each tumor for activity and dose calculation. The proposed method excludes a margin of 11 mm emitting range around tumor volumes from normal liver to investigate the impact on activity calculation. Activity and dose calculation was performed for five patients using the body-surface-area (BSA) method, the classical and territorial partition model.ResultsThe territorial model reaches smaller normal liver doses and significant higher tumor doses compared to the classical partition model. The exclusion of a small region around tumors has a significant impact on mean liver dose. Determined tumor activities for the proposed method are higher in all patients when limited by normal liver dose. Activity calculation based on BSA achieves in all cases the lowest amount.ConclusionsThe territorial model provides a more local and patient-individual dose distribution in normal liver taking into account arterial supply areas. This proposed arterial liver territory-based partition model may be used for SPECT-independent activity calculation and dose prediction under the condition of an artery-based simulation for particle distribution.

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Semi-Quantitative Analysis of Post-Transarterial Radioembolization 90Y Microsphere Positron Emission Tomography Combined with Computed Tomography (PET/CT) Images in Advanced Liver Malignancy: Comparison With 99mTc Macroaggregated Albumin (MAA) Single Photon Emission Computed Tomography (SPECT)

Cited by 20 publications

References 32 publications

Personalised Dosimetry in Radioembolisation for HCC: Impact on Clinical Outcome and on Trial Design

Personalised Dosimetry in Radioembolisation for HCC: Impact on Clinical Outcome and on Trial Design

Standardized Uptake Value Using Thyroid Quantitative SPECT/CT for the Diagnosis and Evaluation of Graves’ Disease: A Prospective Multicenter Study

Predictive SIRT dosimetry based on a territorial model

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