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Erschienen in: European Journal of Nuclear Medicine and Molecular Imaging 8/2019

16.05.2019 | Guidelines

Clinical and dosimetric considerations for Y90: recommendations from an international multidisciplinary working group

verfasst von: Riad Salem, Siddharth A. Padia, Marnix Lam, Jon Bell, Carlo Chiesa, Kirk Fowers, Bonnie Hamilton, Joseph Herman, S. Cheenu Kappadath, Thomas Leung, Lorraine Portelance, Daniel Sze, Etienne Garin

Erschienen in: European Journal of Nuclear Medicine and Molecular Imaging | Ausgabe 8/2019

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Abstract

The TheraSphere Global Dosimetry Steering Committee was formed in 2017 by BTG International to review existing data and address gaps in knowledge related to dosimetry. This committee is comprised of health care providers with diverse areas of expertise and perspectives on radiation dosimetry. The goal of these recommendations is to optimize glass microspheres radiation therapy for hepatocellular carcinoma while accounting for variables including disease presentation, tumour vascularity, liver function, and curative/palliative intent. The recommendations aim to unify glass microsphere users behind standardized dosimetry methodology that is simple, reproducible and supported by clinical data, with the overarching goal of improving clinical outcomes and advancing the knowledge of dosimetry.
Literatur
2.
Zurück zum Zitat Benson AB, D'Angelica MI, Abrams TA, Are C, Bloomston PM, Chang DT, et al. Hepatobiliary cancers, version 2.2014. J Natl Compr Cancer Netw. 2014;12:1152–82.CrossRef Benson AB, D'Angelica MI, Abrams TA, Are C, Bloomston PM, Chang DT, et al. Hepatobiliary cancers, version 2.2014. J Natl Compr Cancer Netw. 2014;12:1152–82.CrossRef
4.
Zurück zum Zitat Yttrium S-S. Resin microspheres [package insert]. North Sydney. Australia: SirTex Medical; 2013. Yttrium S-S. Resin microspheres [package insert]. North Sydney. Australia: SirTex Medical; 2013.
5.
Zurück zum Zitat BTG. Insert–TheraSphere P. Yttrium-90 glass microspheres–rev. 12. Biocompatibles UK Ltd, a BTG international group company. BTG. Insert–TheraSphere P. Yttrium-90 glass microspheres–rev. 12. Biocompatibles UK Ltd, a BTG international group company.
8.
Zurück zum Zitat Garin E, Rolland Y, Edeline J, Icard N, Lenoir L, Laffont S, et al. Personalized dosimetry with intensification using 90Y-loaded glass microsphere radioembolization induces prolonged overall survival in hepatocellular carcinoma patients with portal vein thrombosis. J Nucl Med: Off Publ, Soc Nucl Med. 2015;56:339–46. https://doi.org/10.2967/jnumed.114.145177.CrossRef Garin E, Rolland Y, Edeline J, Icard N, Lenoir L, Laffont S, et al. Personalized dosimetry with intensification using 90Y-loaded glass microsphere radioembolization induces prolonged overall survival in hepatocellular carcinoma patients with portal vein thrombosis. J Nucl Med: Off Publ, Soc Nucl Med. 2015;56:339–46. https://​doi.​org/​10.​2967/​jnumed.​114.​145177.CrossRef
13.
Zurück zum Zitat Chiesa C, Lambert B, Maccauro M, Ezziddin S, Ahmadzadehfar H, Dieudonne A, et al. Pretreatment dosimetry in HCC radioembolization with (90)Y glass microspheres cannot be invalidated with a bare visual evaluation of (99m)Tc-MAA uptake of colorectal metastases treated with resin microspheres. J Nucl Medi: Off Publ Soc Nucl Med. 2014;55:1215–6. https://doi.org/10.2967/jnumed.113.129361.CrossRef Chiesa C, Lambert B, Maccauro M, Ezziddin S, Ahmadzadehfar H, Dieudonne A, et al. Pretreatment dosimetry in HCC radioembolization with (90)Y glass microspheres cannot be invalidated with a bare visual evaluation of (99m)Tc-MAA uptake of colorectal metastases treated with resin microspheres. J Nucl Medi: Off Publ Soc Nucl Med. 2014;55:1215–6. https://​doi.​org/​10.​2967/​jnumed.​113.​129361.CrossRef
14.
Zurück zum Zitat Ulrich G, Dudeck O, Furth C, Ruf J, Grosser OS, Adolf D, et al. Predictive value of intratumoral 99mTc-macroaggregated albumin uptake in patients with colorectal liver metastases scheduled for radioembolization with 90Y-microspheres. J Nucl Medi: Off Publ Soc Nucl Med. 2013;54:516–22. https://doi.org/10.2967/jnumed.112.112508.CrossRef Ulrich G, Dudeck O, Furth C, Ruf J, Grosser OS, Adolf D, et al. Predictive value of intratumoral 99mTc-macroaggregated albumin uptake in patients with colorectal liver metastases scheduled for radioembolization with 90Y-microspheres. J Nucl Medi: Off Publ Soc Nucl Med. 2013;54:516–22. https://​doi.​org/​10.​2967/​jnumed.​112.​112508.CrossRef
15.
Zurück zum Zitat Chan K, Alessio A, Johnson G, Vaidya S, Kwan S, Monsky W, et al. Prospective trial using internal pair-production positron emission tomography to establish the Yttrium-90 radioembolization dose required for response of hepatic tumors. Int J Radiat Oncol Biol Phys. 2018;101(2):358–365. Chan K, Alessio A, Johnson G, Vaidya S, Kwan S, Monsky W, et al. Prospective trial using internal pair-production positron emission tomography to establish the Yttrium-90 radioembolization dose required for response of hepatic tumors. Int J Radiat Oncol Biol Phys. 2018;101(2):358–365.
18.
Zurück zum Zitat Gulec SA, Mesoloras G, Stabin M. Dosimetric techniques in 90Y-microsphere therapy of liver cancer: the MIRD equations for dose calculations. J Nucl Medi: Off Publ Soc Nucl Med. 2006;47:1209–11. Gulec SA, Mesoloras G, Stabin M. Dosimetric techniques in 90Y-microsphere therapy of liver cancer: the MIRD equations for dose calculations. J Nucl Medi: Off Publ Soc Nucl Med. 2006;47:1209–11.
19.
Zurück zum Zitat Dezarn WA, Cessna JT, DeWerd LA, Feng W, Gates VL, Halama J, et al. Recommendations of the American Association of Physicists in Medicine on dosimetry, imaging, and quality assurance procedures for 90Y microsphere brachytherapy in the treatment of hepatic malignancies. Med Phys. 2011;38:4824–45. https://doi.org/10.1118/1.3608909.CrossRefPubMed Dezarn WA, Cessna JT, DeWerd LA, Feng W, Gates VL, Halama J, et al. Recommendations of the American Association of Physicists in Medicine on dosimetry, imaging, and quality assurance procedures for 90Y microsphere brachytherapy in the treatment of hepatic malignancies. Med Phys. 2011;38:4824–45. https://​doi.​org/​10.​1118/​1.​3608909.CrossRefPubMed
20.
Zurück zum Zitat Salem R, Thurston KG, Carr BI, Goin JE, Geschwind JF. Yttrium-90 microspheres: radiation therapy for unresectable liver cancer. J Vasc Interv Radiol: JVIR. 2002;13:S223–9.CrossRefPubMed Salem R, Thurston KG, Carr BI, Goin JE, Geschwind JF. Yttrium-90 microspheres: radiation therapy for unresectable liver cancer. J Vasc Interv Radiol: JVIR. 2002;13:S223–9.CrossRefPubMed
24.
25.
Zurück zum Zitat Biederman DM, Titano JJ, Bishay VL, Durrani RJ, Dayan E, Tabori N, et al. Radiation segmentectomy versus TACE combined with microwave ablation for unresectable solitary hepatocellular carcinoma up to 3 cm: a propensity score matching study. Radiology. 2016:160718. https://doi.org/10.1148/radiol.2016160718. Biederman DM, Titano JJ, Bishay VL, Durrani RJ, Dayan E, Tabori N, et al. Radiation segmentectomy versus TACE combined with microwave ablation for unresectable solitary hepatocellular carcinoma up to 3 cm: a propensity score matching study. Radiology. 2016:160718. https://​doi.​org/​10.​1148/​radiol.​2016160718.
28.
Zurück zum Zitat Vouche M, Habib A, Ward TJ, Kim E, Kulik L, Ganger D, et al. Unresectable solitary hepatocellular carcinoma not amenable to radiofrequency ablation: multicenter radiology-pathology correlation and survival of radiation segmentectomy. Hepatol (Baltimore, Md). 2014;60:192–201. https://doi.org/10.1002/hep.27057.CrossRef Vouche M, Habib A, Ward TJ, Kim E, Kulik L, Ganger D, et al. Unresectable solitary hepatocellular carcinoma not amenable to radiofrequency ablation: multicenter radiology-pathology correlation and survival of radiation segmentectomy. Hepatol (Baltimore, Md). 2014;60:192–201. https://​doi.​org/​10.​1002/​hep.​27057.CrossRef
32.
40.
Zurück zum Zitat Riaz A, Gabr A, Abouchaleh N, Ali R, Al Asadi A, Mora R, et al. Radioembolization for hepatocellular carcinoma: statistical confirmation of improved survival in responders by landmark analyses. Hepatol (Baltimore, Md). 2018;67:873–83. https://doi.org/10.1002/hep.29480.CrossRef Riaz A, Gabr A, Abouchaleh N, Ali R, Al Asadi A, Mora R, et al. Radioembolization for hepatocellular carcinoma: statistical confirmation of improved survival in responders by landmark analyses. Hepatol (Baltimore, Md). 2018;67:873–83. https://​doi.​org/​10.​1002/​hep.​29480.CrossRef
41.
44.
Zurück zum Zitat Palard X, Edeline J, Rolland Y, Le Sourd S, Pracht M, Laffont S, et al. Dosimetric parameters predicting contralateral liver hypertrophy after unilobar radioembolization of hepatocellular carcinoma. Eur J Nucl Med Mol Imaging. 2017;45(3):392-401. https://doi.org/10.1007/s00259-017-3845-7. Palard X, Edeline J, Rolland Y, Le Sourd S, Pracht M, Laffont S, et al. Dosimetric parameters predicting contralateral liver hypertrophy after unilobar radioembolization of hepatocellular carcinoma. Eur J Nucl Med Mol Imaging. 2017;45(3):392-401. https://​doi.​org/​10.​1007/​s00259-017-3845-7.
48.
Zurück zum Zitat Chiesa C, Maccauro M, Romito R, Spreafico C, Pellizzari S, Negri A, et al. Need, feasibility and convenience of dosimetric treatment planning in liver selective internal radiation therapy with (90)Y microspheres: the experience of the National Tumor Institute of Milan. Quart J Nucl Med Mol Imaging : Off Publ Italian Assoc Nucl Med (AIMN) [and] Int Assoc Radiopharmacol (IAR), [and] Sect So. 2011;55:168–97. Chiesa C, Maccauro M, Romito R, Spreafico C, Pellizzari S, Negri A, et al. Need, feasibility and convenience of dosimetric treatment planning in liver selective internal radiation therapy with (90)Y microspheres: the experience of the National Tumor Institute of Milan. Quart J Nucl Med Mol Imaging : Off Publ Italian Assoc Nucl Med (AIMN) [and] Int Assoc Radiopharmacol (IAR), [and] Sect So. 2011;55:168–97.
49.
Zurück zum Zitat Chan KT, Alessio AM, Johnson GE, Vaidya S, Kwan SW, Monsky W, et al. Hepatotoxic dose thresholds by positron-emission tomography after Yttrium-90 Radioembolization of liver tumors: a prospective single-arm observational study. Cardiovasc Intervent Radiol. 2018;41(9):1363-1372. https://doi.org/10.1007/s00270-018-1949-5. Chan KT, Alessio AM, Johnson GE, Vaidya S, Kwan SW, Monsky W, et al. Hepatotoxic dose thresholds by positron-emission tomography after Yttrium-90 Radioembolization of liver tumors: a prospective single-arm observational study. Cardiovasc Intervent Radiol. 2018;41(9):1363-1372. https://​doi.​org/​10.​1007/​s00270-018-1949-5.
51.
Zurück zum Zitat Salem R, Gabr A, Riaz A, Mora R, Ali R, Abecassis M, et al. Institutional decision to adopt Y90 as primary treatment for HCC informed by a 1,000-patient 15-year experience. Hepatol (Baltimore, Md). 2017. https://doi.org/10.1002/hep.29691. Salem R, Gabr A, Riaz A, Mora R, Ali R, Abecassis M, et al. Institutional decision to adopt Y90 as primary treatment for HCC informed by a 1,000-patient 15-year experience. Hepatol (Baltimore, Md). 2017. https://​doi.​org/​10.​1002/​hep.​29691.
54.
Zurück zum Zitat Haste P, Tann M, Persohn S, LaRoche T, Aaron V, Mauxion T, et al. Correlation of technetium-99m macroaggregated albumin and Yttrium-90 glass microsphere biodistribution in hepatocellular carcinoma: a retrospective review of pretreatment single photon emission CT and posttreatment positron emission tomography/CT. J Vasc Interv Radiol: JVIR. 2017;28:722–30.e1. https://doi.org/10.1016/j.jvir.2016.12.1221.CrossRefPubMed Haste P, Tann M, Persohn S, LaRoche T, Aaron V, Mauxion T, et al. Correlation of technetium-99m macroaggregated albumin and Yttrium-90 glass microsphere biodistribution in hepatocellular carcinoma: a retrospective review of pretreatment single photon emission CT and posttreatment positron emission tomography/CT. J Vasc Interv Radiol: JVIR. 2017;28:722–30.e1. https://​doi.​org/​10.​1016/​j.​jvir.​2016.​12.​1221.CrossRefPubMed
55.
Zurück zum Zitat Balagopal A, Kappadath C. Characterization of 90Y-SPECT/CT self-calibration approaches on the quantification of voxel-level absorbed doses following 90Y-microsphere selective internal radiation therapy. Med Phys. 2017. https://doi.org/10.1002/mp.12695. Balagopal A, Kappadath C. Characterization of 90Y-SPECT/CT self-calibration approaches on the quantification of voxel-level absorbed doses following 90Y-microsphere selective internal radiation therapy. Med Phys. 2017. https://​doi.​org/​10.​1002/​mp.​12695.
56.
60.
Zurück zum Zitat Abouchaleh N, Gabr A, Ali R, Al Asadi A, Mora RA, Kallini JR, et al. Y90 Radioembolization for locally advanced hepatocellular carcinoma with portal vein thrombosis: long-term outcomes in a 185-patient cohort. J Nucl Medi: Off Publ Soc Nucl Med. 2017. https://doi.org/10.2967/jnumed.117.199752. Abouchaleh N, Gabr A, Ali R, Al Asadi A, Mora RA, Kallini JR, et al. Y90 Radioembolization for locally advanced hepatocellular carcinoma with portal vein thrombosis: long-term outcomes in a 185-patient cohort. J Nucl Medi: Off Publ Soc Nucl Med. 2017. https://​doi.​org/​10.​2967/​jnumed.​117.​199752.
61.
Zurück zum Zitat Vilgrain V, Pereira H, Assenat E, Guiu B, Ilonca AD, Pageaux GP, et al. Efficacy and safety of selective internal radiotherapy with yttrium-90 resin microspheres compared with sorafenib in locally advanced and inoperable hepatocellular carcinoma (SARAH): an open-label randomised controlled phase 3 trial. Lancet Oncol. 2017;18:1624–36. https://doi.org/10.1016/s1470-2045(17)30683-6.CrossRefPubMed Vilgrain V, Pereira H, Assenat E, Guiu B, Ilonca AD, Pageaux GP, et al. Efficacy and safety of selective internal radiotherapy with yttrium-90 resin microspheres compared with sorafenib in locally advanced and inoperable hepatocellular carcinoma (SARAH): an open-label randomised controlled phase 3 trial. Lancet Oncol. 2017;18:1624–36. https://​doi.​org/​10.​1016/​s1470-2045(17)30683-6.CrossRefPubMed
65.
Zurück zum Zitat Ho CL, Chen S, Cheung SK, Leung YL, Cheng KC, Wong KN, et al. Radioembolization with (90)Y glass microspheres for hepatocellular carcinoma: significance of pretreatment (11)C-acetate and (18)F-FDG PET/CT and posttreatment (90)Y PET/CT in individualized dose prescription. Eur J Nucl Med Mol Imaging. 2018. https://doi.org/10.1007/s00259-018-4064-6. Ho CL, Chen S, Cheung SK, Leung YL, Cheng KC, Wong KN, et al. Radioembolization with (90)Y glass microspheres for hepatocellular carcinoma: significance of pretreatment (11)C-acetate and (18)F-FDG PET/CT and posttreatment (90)Y PET/CT in individualized dose prescription. Eur J Nucl Med Mol Imaging. 2018. https://​doi.​org/​10.​1007/​s00259-018-4064-6.
Metadaten
Titel
Clinical and dosimetric considerations for Y90: recommendations from an international multidisciplinary working group
verfasst von
Riad Salem
Siddharth A. Padia
Marnix Lam
Jon Bell
Carlo Chiesa
Kirk Fowers
Bonnie Hamilton
Joseph Herman
S. Cheenu Kappadath
Thomas Leung
Lorraine Portelance
Daniel Sze
Etienne Garin
Publikationsdatum
16.05.2019
Verlag
Springer Berlin Heidelberg
Erschienen in
European Journal of Nuclear Medicine and Molecular Imaging / Ausgabe 8/2019
Print ISSN: 1619-7070
Elektronische ISSN: 1619-7089
DOI
https://doi.org/10.1007/s00259-019-04340-5

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