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Erschienen in: European Journal of Nuclear Medicine and Molecular Imaging 4/2020

06.08.2019 | Original Article

Comparative dosimetry between 99mTc-MAA SPECT/CT and 90Y PET/CT in primary and metastatic liver tumors

verfasst von: Alexandre Jadoul, Claire Bernard, Pierre Lovinfosse, Laurent Gérard, Henri Lilet, Olivier Cornet, Roland Hustinx

Erschienen in: European Journal of Nuclear Medicine and Molecular Imaging | Ausgabe 4/2020

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Abstract

Introduction

The aim of this study is to determine whether 99mTc-MAA SPECT/CT-based dosimetry could predict the actual absorbed dose in hepatocellular carcinoma (HCC) or liver metastases, treated by glass or resin microspheres.

Material and methods

Fifty-seven patients who underwent selective internal radiation therapy (SIRT) were retrospectively included in the study, for a total of 59 treatments. Nineteen HCC were treated by resin microspheres (HCC-SIR), 20 HCC with glass microspheres (HCC-Thera), and 20 liver metastases with resin microspheres (Metastases-SIR). The mean absorbed doses in tumoral liver (Dm) and non-tumoral liver (DmNTL) were determined on the 99mTc-MAA SPECT/CT and the 90Y PET/CT, and compared with each other.

Results

DmNTL was < 50 Gy in the 3 groups, with a strong correlation in all population, albeit slightly lower in Metastases-SIR than HCC-SIR and HCC-Thera (CCC 0.8, 0.94 and 0.96, respectively). In tumoral liver, Dm was higher in HCC than metastases (159 ± 117 Gy versus 63 ± 31 Gy). 99mTc-MAA SPECT/CT proved to be a better indicator of Dm in HCC compared with metastases, with similar 99mTc-MAA-90Y concordance in resin and glass microspheres (CCC HCC-SIR 0.82, CCC HCC-Thera 0.82, and CCC Metastases-SIR 0.52).

Conclusion

99mTc-MAA SPECT/CT is a reasonably reliable tool for predicting the dose to the non-tumoral liver in both HCC and metastases, regardless of the type of microspheres. It is also fairly reliable for predicting the tumor dose in HCC, again regardless of the type of spheres, although individual variations are observed.
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Literatur
1.
Zurück zum Zitat Sangro B, Salem R, Kennedy A, et al. Radioembolization for hepatocellular carcinoma : a review of the evidence and treatment recommendations. Am J Clin Oncol. 2011;34:422–31.CrossRef Sangro B, Salem R, Kennedy A, et al. Radioembolization for hepatocellular carcinoma : a review of the evidence and treatment recommendations. Am J Clin Oncol. 2011;34:422–31.CrossRef
2.
Zurück zum Zitat Saxena A, Bester L, Shan L, et al. A systematic review on the safety and efficacy of yttrium-90 radioembolization for unresectable, chemorefractory colorectal cancer liver metastases. J Cancer Res Clin Oncol. 2014;140(4):537–47.CrossRef Saxena A, Bester L, Shan L, et al. A systematic review on the safety and efficacy of yttrium-90 radioembolization for unresectable, chemorefractory colorectal cancer liver metastases. J Cancer Res Clin Oncol. 2014;140(4):537–47.CrossRef
3.
Zurück zum Zitat Fan KY, Wild AT, Halappa VG, et al. Neuroendocrine tumor liver metastases treated with yttrium-90 radioembolization. Contemp Clin Trials. 2016;50:143–9.CrossRef Fan KY, Wild AT, Halappa VG, et al. Neuroendocrine tumor liver metastases treated with yttrium-90 radioembolization. Contemp Clin Trials. 2016;50:143–9.CrossRef
4.
Zurück zum Zitat European Association for the Study of the Liver. EASL clinical practice guidelines: management of hepatocellular carcinoma. J Hepatol. 2018;69(1):182–236.CrossRef European Association for the Study of the Liver. EASL clinical practice guidelines: management of hepatocellular carcinoma. J Hepatol. 2018;69(1):182–236.CrossRef
5.
Zurück zum Zitat Van Cutsem E, Cervantes A, Adam R, et al. ESMO consensus guidelines for the management of patients with metastatic colorectal cancer. Ann Oncol. 2016;27(8):1386–422.CrossRef Van Cutsem E, Cervantes A, Adam R, et al. ESMO consensus guidelines for the management of patients with metastatic colorectal cancer. Ann Oncol. 2016;27(8):1386–422.CrossRef
6.
Zurück zum Zitat Wasan HS, Gibbs P, Sharma NK, et al. First-line selective internal radiotherapy plus chemotherapy versus chemotherapy alone in patients with liver metastases from colorectal cancer (FOXFIRE, SIRFLOX, and FOXFIRE-Global): a combined analysis of three multicentre, randomised, phase 3 trials. Lancet Oncol. 2017;18(9):1159–71.CrossRef Wasan HS, Gibbs P, Sharma NK, et al. First-line selective internal radiotherapy plus chemotherapy versus chemotherapy alone in patients with liver metastases from colorectal cancer (FOXFIRE, SIRFLOX, and FOXFIRE-Global): a combined analysis of three multicentre, randomised, phase 3 trials. Lancet Oncol. 2017;18(9):1159–71.CrossRef
7.
Zurück zum Zitat Vilgrain V, Pereira H, Assenat E, 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.CrossRef Vilgrain V, Pereira H, Assenat E, 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.CrossRef
8.
Zurück zum Zitat Chow PKH, Gandhi M, Tan S-B, et al. SIRveNIB: selective internal radiation therapy vs. sorafenib in Asia-Pacific patients with hepatocellular carcinoma. J Clin Oncol. 2018;36(19):1913–21.CrossRef Chow PKH, Gandhi M, Tan S-B, et al. SIRveNIB: selective internal radiation therapy vs. sorafenib in Asia-Pacific patients with hepatocellular carcinoma. J Clin Oncol. 2018;36(19):1913–21.CrossRef
9.
Zurück zum Zitat Salem R, Lewandowski RJ, Kulik L, et al. Radioembolization results in longer time-to-progression and reduced toxicity compared with chemoembolization in patients with hepatocellular carcinoma. Gastroenterology. 2011;140:497–507.CrossRef Salem R, Lewandowski RJ, Kulik L, et al. Radioembolization results in longer time-to-progression and reduced toxicity compared with chemoembolization in patients with hepatocellular carcinoma. Gastroenterology. 2011;140:497–507.CrossRef
10.
Zurück zum Zitat Memon K, Kulik L, Lewandowski RJ, et al. Prospective evaluation of patients with early-/intermediate-stage hepatocellular carcinoma with disease progression following arterial locoregional therapy: candidacy for systemic treatment or clinical trials. J Vasc Interv Radiol. 2013;24(8):1189–97.CrossRef Memon K, Kulik L, Lewandowski RJ, et al. Prospective evaluation of patients with early-/intermediate-stage hepatocellular carcinoma with disease progression following arterial locoregional therapy: candidacy for systemic treatment or clinical trials. J Vasc Interv Radiol. 2013;24(8):1189–97.CrossRef
11.
Zurück zum Zitat Salem R, Gilbertsen M, Butt Z, et al. Increased quality of life among hepatocellular carcinoma patients treated with radioembolization, compared with chemoembolization. Clin Gastroenterol Hepatol. 2013;11(10):1358–65.CrossRef Salem R, Gilbertsen M, Butt Z, et al. Increased quality of life among hepatocellular carcinoma patients treated with radioembolization, compared with chemoembolization. Clin Gastroenterol Hepatol. 2013;11(10):1358–65.CrossRef
12.
Zurück zum Zitat Braat AJAT, Kappadath SC, Bruijnen RCG, et al. Adequate SIRT activity dose is as important as adequate chemotherapy dose. Lancet Oncol. 2017;18(11):e636.CrossRef Braat AJAT, Kappadath SC, Bruijnen RCG, et al. Adequate SIRT activity dose is as important as adequate chemotherapy dose. Lancet Oncol. 2017;18(11):e636.CrossRef
13.
Zurück zum Zitat Garin E, Rolland Y, Campillo-Gimenez B, et al. Negative phase 3 study of 90Y microspheres versus sorafenib in HCC. Lancet Oncol. 2018;19(2):e70.CrossRef Garin E, Rolland Y, Campillo-Gimenez B, et al. Negative phase 3 study of 90Y microspheres versus sorafenib in HCC. Lancet Oncol. 2018;19(2):e70.CrossRef
14.
Zurück zum Zitat Garin E, Lenoir L, Edeline J, et al. Boosted selective internal radiation therapy with 90Y-loaded glass microspheres (B-SIRT) for hepatocellular carcinoma patients: a new personalized promising concept. Eur J Nucl Med Mol Imaging. 2013;40(7):1057–68.CrossRef Garin E, Lenoir L, Edeline J, et al. Boosted selective internal radiation therapy with 90Y-loaded glass microspheres (B-SIRT) for hepatocellular carcinoma patients: a new personalized promising concept. Eur J Nucl Med Mol Imaging. 2013;40(7):1057–68.CrossRef
15.
Zurück zum Zitat Garin E, Rolland Y, Pracht M, et al. High impact of macroaggregated albumin-based tumour dose on response and overall survival in hepatocellular carcinoma patients treated with 90 Y-loaded glass microsphere radioembolization. Liver Int. 2017;37(1):101–10.CrossRef Garin E, Rolland Y, Pracht M, et al. High impact of macroaggregated albumin-based tumour dose on response and overall survival in hepatocellular carcinoma patients treated with 90 Y-loaded glass microsphere radioembolization. Liver Int. 2017;37(1):101–10.CrossRef
16.
Zurück zum Zitat Willowson KP, Hayes AR, Chan DLH, et al. Clinical and imaging-based prognostic factors in radioembolisation of liver metastases from colorectal cancer: a retrospective exploratory analysis. EJNMMI Res. 2017;7(1):46.CrossRef Willowson KP, Hayes AR, Chan DLH, et al. Clinical and imaging-based prognostic factors in radioembolisation of liver metastases from colorectal cancer: a retrospective exploratory analysis. EJNMMI Res. 2017;7(1):46.CrossRef
17.
Zurück zum Zitat van den Hoven AF, Rosenbaum CENM, Elias SG, et al. Insights into the dose–response relationship of radioembolization with resin 90Y-microspheres: a prospective cohort study in patients with colorectal cancer liver metastases. J Nucl Med. 2016;57:1014–9.CrossRef van den Hoven AF, Rosenbaum CENM, Elias SG, et al. Insights into the dose–response relationship of radioembolization with resin 90Y-microspheres: a prospective cohort study in patients with colorectal cancer liver metastases. J Nucl Med. 2016;57:1014–9.CrossRef
18.
Zurück zum Zitat Levillain H, Duran Derijckere I, Marin G, et al. 90Y-PET/CT-based dosimetry after selective internal radiation therapy predicts outcome in patients with liver metastases from colorectal cancer. EJNMMI Res. 2018;8(1):60.CrossRef Levillain H, Duran Derijckere I, Marin G, et al. 90Y-PET/CT-based dosimetry after selective internal radiation therapy predicts outcome in patients with liver metastases from colorectal cancer. EJNMMI Res. 2018;8(1):60.CrossRef
19.
Zurück zum Zitat Lam MG, Goris ML, Iagaru AH, et al. Prognostic utility of 90Y radioembolizationdosimetry based on fusion 99mTc-macroaggregated albumin-99mTc-sulfur colloid SPECT. J Nucl Med. 2013;54(12):2055–61.CrossRef Lam MG, Goris ML, Iagaru AH, et al. Prognostic utility of 90Y radioembolizationdosimetry based on fusion 99mTc-macroaggregated albumin-99mTc-sulfur colloid SPECT. J Nucl Med. 2013;54(12):2055–61.CrossRef
20.
Zurück zum Zitat Flamen P, Vanderlinden B, Delatte P, et al. Multimodality imaging can predict the metabolic response of unresectable colorectal liver metastases to radioembolization therapy with Yttrium-90 labeled resin microspheres. Phys Med Biol. 2008;53(22):6591–603 (Erratum in Phys Med Biol. 2014 May 21;59(10):2549–51).CrossRef Flamen P, Vanderlinden B, Delatte P, et al. Multimodality imaging can predict the metabolic response of unresectable colorectal liver metastases to radioembolization therapy with Yttrium-90 labeled resin microspheres. Phys Med Biol. 2008;53(22):6591–603 (Erratum in Phys Med Biol. 2014 May 21;59(10):2549–51).CrossRef
21.
Zurück zum Zitat Gnesin S, Canetti L, Adib S, et al. Partition model-based 99mTc-MAA SPECT/CT predictive dosimetry compared with 90Y TOF PET/CT posttreatment dosimetry in radioembolization of hepatocellular carcinoma: a quantitative agreement comparison. J Nucl Med. 2016;57(11):1672–8.CrossRef Gnesin S, Canetti L, Adib S, et al. Partition model-based 99mTc-MAA SPECT/CT predictive dosimetry compared with 90Y TOF PET/CT posttreatment dosimetry in radioembolization of hepatocellular carcinoma: a quantitative agreement comparison. J Nucl Med. 2016;57(11):1672–8.CrossRef
22.
Zurück zum Zitat Haste P, Tann M, Persohn S, 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. 2017;28(5):722–30.CrossRef Haste P, Tann M, Persohn S, 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. 2017;28(5):722–30.CrossRef
23.
Zurück zum Zitat Kao YH, Steinberg JD, Tay YS, et al. Post-radioembolization yttrium-90 PET/CT - part 2: dose-response and tumor predictive dosimetry for resin microspheres. EJNMMI Res. 2013;3(1):57.CrossRef Kao YH, Steinberg JD, Tay YS, et al. Post-radioembolization yttrium-90 PET/CT - part 2: dose-response and tumor predictive dosimetry for resin microspheres. EJNMMI Res. 2013;3(1):57.CrossRef
24.
Zurück zum Zitat Dickinson NJ, Kalirai C, O'Connor RA, et al. Hepatic selective internal radiation therapy: how well does pretreatment 99mTc-macroaggregated albumin activity distribution and quantification agree with post-therapy bremsstrahlung imaging? Nucl Med Commun. 2018;39(9):809–17.CrossRef Dickinson NJ, Kalirai C, O'Connor RA, et al. Hepatic selective internal radiation therapy: how well does pretreatment 99mTc-macroaggregated albumin activity distribution and quantification agree with post-therapy bremsstrahlung imaging? Nucl Med Commun. 2018;39(9):809–17.CrossRef
25.
Zurück zum Zitat Pasciak A, Bourgeois A, Bradley Y. A comparison of techniques for 90Y PET/CT image-based dosimetry following radioembolization with resin microspheres. Front Oncol. 2014;4:121.PubMedPubMedCentral Pasciak A, Bourgeois A, Bradley Y. A comparison of techniques for 90Y PET/CT image-based dosimetry following radioembolization with resin microspheres. Front Oncol. 2014;4:121.PubMedPubMedCentral
26.
Zurück zum Zitat Allred JD, Niedbala J, Mikell JK, et al. The value of 99mTc-MAA SPECT/CT for lung shunt estimation in 90Y radioembolization: a phantom and patient study. EJNMMI Res. 2018;8(1):50.CrossRef Allred JD, Niedbala J, Mikell JK, et al. The value of 99mTc-MAA SPECT/CT for lung shunt estimation in 90Y radioembolization: a phantom and patient study. EJNMMI Res. 2018;8(1):50.CrossRef
27.
Zurück zum Zitat Garin E, Rolland Y, Edeline J, 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. 2015;56(3):339–46.CrossRef Garin E, Rolland Y, Edeline J, 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. 2015;56(3):339–46.CrossRef
28.
Zurück zum Zitat Ho S, Lau WY, Leung TWT, et al. Clinical evaluation of the partition model for estimating radiation doses from yttrium-90 microspheres in the treatment of hepatic cancers. Eur J Nucl Med. 1997;24:293–8.PubMed Ho S, Lau WY, Leung TWT, et al. Clinical evaluation of the partition model for estimating radiation doses from yttrium-90 microspheres in the treatment of hepatic cancers. Eur J Nucl Med. 1997;24:293–8.PubMed
29.
Zurück zum Zitat Chiesa C, Maccauro M, Romito R, et al. Need, feasibility and convenience of dosimetric treatment planning in liver selective internal radiation therapy with 90Y microspheres: the experience of the National Tumor Institute of Milan. Q J Nucl Med Mol Imaging. 2011;55(2):168–97.PubMed Chiesa C, Maccauro M, Romito R, et al. Need, feasibility and convenience of dosimetric treatment planning in liver selective internal radiation therapy with 90Y microspheres: the experience of the National Tumor Institute of Milan. Q J Nucl Med Mol Imaging. 2011;55(2):168–97.PubMed
30.
Zurück zum Zitat Kao YH, Hock Tan AE, Burgmans MC, et al. Image-guided personalized predictive dosimetry by artery-specific SPECT/CT partition modeling for safe and effective 90Y radioembolization. J Nucl Med. 2012;53(4):559–66.CrossRef Kao YH, Hock Tan AE, Burgmans MC, et al. Image-guided personalized predictive dosimetry by artery-specific SPECT/CT partition modeling for safe and effective 90Y radioembolization. J Nucl Med. 2012;53(4):559–66.CrossRef
31.
Zurück zum Zitat Wondergem M, Smits ML, Elschot M, et al. 99mTc-macroaggregated albumin poorly predicts the intrahepatic distribution of 90Y resin microspheres in hepatic radioembolization. J Nucl Med. 2013;54(8):1294–301.CrossRef Wondergem M, Smits ML, Elschot M, et al. 99mTc-macroaggregated albumin poorly predicts the intrahepatic distribution of 90Y resin microspheres in hepatic radioembolization. J Nucl Med. 2013;54(8):1294–301.CrossRef
32.
Zurück zum Zitat Ulrich G, Dudeck O, Furth C, et al. Predictive value of intratumoral 99mTc-macroaggregated albumin uptake in patients with colorectal liver metastases scheduled for radioembolization with 90Y-microspheres. J Nucl Med. 2013;54(4):516–22.CrossRef Ulrich G, Dudeck O, Furth C, et al. Predictive value of intratumoral 99mTc-macroaggregated albumin uptake in patients with colorectal liver metastases scheduled for radioembolization with 90Y-microspheres. J Nucl Med. 2013;54(4):516–22.CrossRef
33.
Zurück zum Zitat Van de Wiele C, Maes A, Brugman E, et al. SIRT of liver metastases: physiological and pathophysiological considerations. Eur J Nucl Med Mol Imaging. 2012;39(10):1646–55.CrossRef Van de Wiele C, Maes A, Brugman E, et al. SIRT of liver metastases: physiological and pathophysiological considerations. Eur J Nucl Med Mol Imaging. 2012;39(10):1646–55.CrossRef
34.
Zurück zum Zitat Badiyan S, Bhooshan N, Chuong MD, et al. Correlation of radiation dose and activity with clinical outcomes in metastatic colorectal cancer after selective internal radiation therapy using yttrium-90 resin microspheres. Nucl Med Commun. 2018;39(10):915–20.CrossRef Badiyan S, Bhooshan N, Chuong MD, et al. Correlation of radiation dose and activity with clinical outcomes in metastatic colorectal cancer after selective internal radiation therapy using yttrium-90 resin microspheres. Nucl Med Commun. 2018;39(10):915–20.CrossRef
35.
Zurück zum Zitat Spreafico C, Maccauro M, Mazzaferro V, et al. The dosimetric importance of the number of 90Y microspheres in liver transarterial radioembolization (TARE). Eur J Nucl Med Mol Imaging. 2014;41(4):634–8.CrossRef Spreafico C, Maccauro M, Mazzaferro V, et al. The dosimetric importance of the number of 90Y microspheres in liver transarterial radioembolization (TARE). Eur J Nucl Med Mol Imaging. 2014;41(4):634–8.CrossRef
36.
Zurück zum Zitat Chiesa C, Mira M, Maccauro M, et al. A dosimetric treatment planning strategy in radioembolization of hepatocarcinoma with 90Y glass microspheres. Q J Nucl Med Mol Imaging. 2012;56(6):503–8.PubMed Chiesa C, Mira M, Maccauro M, et al. A dosimetric treatment planning strategy in radioembolization of hepatocarcinoma with 90Y glass microspheres. Q J Nucl Med Mol Imaging. 2012;56(6):503–8.PubMed
37.
Zurück zum Zitat Garin E, Rolland Y, Laffont S, et al. Clinical impact of (99m)Tc-MAA SPECT/CT-based dosimetry in the radioembolization of liver malignancies with (90)Y-loaded microspheres. Eur J Nucl Med Mol Imaging. 2016;43(3):559–75.CrossRef Garin E, Rolland Y, Laffont S, et al. Clinical impact of (99m)Tc-MAA SPECT/CT-based dosimetry in the radioembolization of liver malignancies with (90)Y-loaded microspheres. Eur J Nucl Med Mol Imaging. 2016;43(3):559–75.CrossRef
Metadaten
Titel
Comparative dosimetry between 99mTc-MAA SPECT/CT and 90Y PET/CT in primary and metastatic liver tumors
verfasst von
Alexandre Jadoul
Claire Bernard
Pierre Lovinfosse
Laurent Gérard
Henri Lilet
Olivier Cornet
Roland Hustinx
Publikationsdatum
06.08.2019
Verlag
Springer Berlin Heidelberg
Erschienen in
European Journal of Nuclear Medicine and Molecular Imaging / Ausgabe 4/2020
Print ISSN: 1619-7070
Elektronische ISSN: 1619-7089
DOI
https://doi.org/10.1007/s00259-019-04465-7

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