Y90 radioembolization of colorectal cancer liver metastases: response assessment by contrast-enhanced computed tomography with or without PET-CT guidance

Vouche, Michaël; Salem, Riad; Miller, F.; Lemort, Marc; Vanderlinden, Bruno; Becker, Daniel De; Hendlisz, Alain; Flamen, Patrick

doi:10.1016/j.clinimag.2014.12.016

Cited by 4 publications

(3 citation statements)

References 31 publications

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“…While generally well tolerated, the main complications of radioembolization are liver toxicity from radiation exposure and non-target embolization [ 8 – 15 ]. Response is generally heterogeneous between patients, even those with the same tumor types [ 16 , 17 ].…”

Section: Introductionmentioning

confidence: 99%

PET/MRI of Hepatic 90Y Microsphere Deposition Determines Individual Tumor Response

Fowler

Maughan

Laforest

et al. 2015

Cardiovasc Intervent Radiol

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PurposeThe purpose of our study is to determine if there is a relationship between dose deposition measured by PET/MRI and individual lesion response to yttrium-90 (90Y) microsphere radioembolization.Materials and Methods26 patients undergoing lobar treatment with 90Y microspheres underwent PET/MRI within 66 h of treatment and had follow-up imaging available. Adequate visualization of tumor was available in 24 patients, and contours were drawn on simultaneously acquired PET/MRI data. Dose volume histograms (DVHs) were extracted from dose maps, which were generated using a voxelized dose kernel. Similar contours to capture dimensional and volumetric change of tumors were drawn on follow-up imaging. Response was analyzed using both RECIST and volumetric RECIST (vRECIST) criteria.ResultsA total of 8 hepatocellular carcinoma (HCC), 4 neuroendocrine tumor (NET), 9 colorectal metastases (CRC) patients, and 3 patients with other metastatic disease met inclusion criteria. Average dose was useful in predicting response between responders and non-responders for all lesion types and for CRC lesions alone using both response criteria (p < 0.05). D70 (minimum dose to 70 % of volume) was also useful in predicting response when using vRECIST. No significant trend was seen in the other tumor types. For CRC lesions, an average dose of 29.8 Gy offered 76.9 % sensitivity and 75.9 % specificity for response.ConclusionsPET/MRI of 90Y microsphere distribution showed significantly higher DVH values for responders than non-responders in patients with CRC. DVH analysis of 90Y microsphere distribution following treatment may be an important predictor of response and could be used to guide future adaptive therapy trials.

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Section: Introductionmentioning

confidence: 99%

PET/MRI of Hepatic 90Y Microsphere Deposition Determines Individual Tumor Response

Fowler

Maughan

Laforest

et al. 2015

Cardiovasc Intervent Radiol

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“…Liver metastases treated with Y-90 therapy have shown decreased metabolic activity on PET scan following treatment, suggesting that PET could potentially be used as a tool in determining tumor response to radioembolization therapy [87][88][89]. Additionally, Sabet et al reported that the amount of metabolic change in lesions of CRLM exhibited by PET scan was related to patient survival [90].…”

Section: Transarterial Chemoembolization and Radioembolizationmentioning

confidence: 95%

Current Status of Imaging to Evaluate Liver Metastases From Colorectal Cancer

Postlewait

Maithel

2015

Curr Colorectal Cancer Rep

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Multiple imaging modalities are routinely used to identify, characterize, and clinically follow colorectal cancer liver metastases. These include ultrasound, computed tomography, magnetic resonance imaging, and positron emission tomography. Within each modality, there exist multiple variations of protocol, which could include addition of contrast, acquisition of specific imaging sequences, or combination of images with those of another modality. In addition to considerations of imaging protocols and equipment, one must also consider patient-specific factors to determine appropriate imaging for colorectal cancer liver metastases. Specifically, whether the patient has been treated systemically or locally is important in determining imaging strategy. This review highlights the benefits, limitations, and variations of each modality and offers comparative data among the imaging techniques.

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“…While generally well tolerated, the main complications of radioembolization are liver toxicity from radiation exposure and non-target embolization [8][9][10][11][12][13][14][15]. Response is generally heterogeneous between patients, even those with the same tumor types [16,17].…”

Section: Introductionmentioning

confidence: 99%

PET/MRI of hepatic 90Y microsphere deposition determines individual tumor response

Saad¹,

Fowler

Maughan

et al. 2016

Journal of Vascular and Interventional Radiology

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Purpose The purpose of our study is to determine if there is a relationship between dose deposition measured by PET/MRI and individual lesion response to yttrium-90 ( 90 Y) microsphere radioembolization. Materials and Methods 26 patients undergoing lobar treatment with 90 Y microspheres underwent PET/MRI within 66 h of treatment and had follow-up imaging available. Adequate visualization of tumor was available in 24 patients, and contours were drawn on simultaneously acquired PET/MRI data. Dose volume histograms (DVHs) were extracted from dose maps, which were generated using a voxelized dose kernel. Similar contours to capture dimensional and volumetric change of tumors were drawn on follow-up imaging. Response was analyzed using both RECIST and volumetric RECIST (vRECIST) criteria.Results A total of 8 hepatocellular carcinoma (HCC), 4 neuroendocrine tumor (NET), 9 colorectal metastases (CRC) patients, and 3 patients with other metastatic disease met inclusion criteria. Average dose was useful in predicting response between responders and non-responders for all lesion types and for CRC lesions alone using both response criteria (p \ 0.05). D70 (minimum dose to 70 % of volume) was also useful in predicting response when using vRECIST. No significant trend was seen in the other tumor types. For CRC lesions, an average dose of 29.8 Gy offered 76.9 % sensitivity and 75.9 % specificity for response. Conclusions PET/MRI of 90 Y microsphere distribution showed significantly higher DVH values for responders than non-responders in patients with CRC. DVH analysis of 90 Y microsphere distribution following treatment may be an important predictor of response and could be used to guide future adaptive therapy trials.

show abstract

Y90 radioembolization of colorectal cancer liver metastases: response assessment by contrast-enhanced computed tomography with or without PET-CT guidance

Cited by 4 publications

References 31 publications

PET/MRI of Hepatic 90Y Microsphere Deposition Determines Individual Tumor Response

PET/MRI of Hepatic 90Y Microsphere Deposition Determines Individual Tumor Response

Current Status of Imaging to Evaluate Liver Metastases From Colorectal Cancer

PET/MRI of hepatic 90Y microsphere deposition determines individual tumor response

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