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European Journal of Nuclear Medicine and Molecular Imaging

Erschienen in:

01.01.2013 | Original Article

Hepatic volume changes induced by radioembolization with ⁹⁰Y resin microspheres. A single-centre study

verfasst von: Hojjat Ahmadzadehfar, Carsten Meyer, Samer Ezziddin, Amir Sabet, Anja Hoff-Meyer, Marianne Muckle, Timur Logvinski, Hans Heinz Schild, Hans Jürgen Biersack, Kai Wilhelm

Erschienen in: European Journal of Nuclear Medicine and Molecular Imaging | Ausgabe 1/2013

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Abstract

Purpose

Lobar radioembolization (RE) of the liver can result in reduction in volume of the ipsilateral lobe as well as hypertrophy of the contralateral lobe. Theoretically, hypertrophy of the contralateral liver lobe after RE could increase the chance of a successful liver resection, especially in patients with limited liver function reserve. The aim of this preliminary study was to evaluate the early effects of RE with resin microspheres on the volumes of the liver lobes and spleen.

Methods

We retrospectively investigated 24 patients (12 women, 44–78 years old) with different types of cancer and liver-dominant metastatic disease who had undergone RE of the liver with resin microspheres. Changes in the volumes of the liver lobes and spleen were quantified by CT before and about 4 to 8 weeks after treatment.

Results

Of the 24 patients, 17 suffered from metastases in both liver lobes (group A) and 7 had metastases only in the right liver lobe (group B). The patients in the group A underwent sequential treatment starting with the right liver lobe. The median administered dose was 1.75 GBq. RE was associated with a median increase in volume of the left liver lobe of 34 % (P < 0.001) and a median decrease in volume of the right liver lobe of 11 % (P = 0.03). The volume of the spleen showed a median increase of 17 % (P = 0.01). Separate analysis of the two groups showed a median increases in volume of the left liver lobe of 30 % (P = 0.001) in group A and 70 % (P = 0.01) in group B. There was no correlation between the injected dose and the volume alteration (r = 0.1–0.3).

Conclusion

RE of the right liver lobe with resin microspheres caused a significant increase in the volume of the left liver lobe. This may allow liver resection in patients with metastases in the right liver lobe and a small left liver lobe.

Salem R, Thurston KG. Radioembolization with 90Yttrium microspheres: a state-of-the-art brachytherapy treatment for primary and secondary liver malignancies. Part 1: Technical and methodologic considerations. J Vasc Interv Radiol. 2006;17:1251–78. doi:10.1097/01.RVI.0000233785.75257.9A.PubMedCrossRef

Abdalla EK, Vauthey JN, Ellis LM, Ellis V, Pollock R, Broglio KR. Recurrence and outcomes following hepatic resection, radiofrequency ablation, and combined resection/ablation for colorectal liver metastases. Ann Surg. 2004;239:818–25. discussion 25–7.PubMedCrossRef

Sangro B, Carpanese L, Cianni R, et al. Survival after yttrium-90 resin microsphere radioembolization of hepatocellular carcinoma across Barcelona clinic liver cancer stages: A European evaluation. Hepatology. 2011;54:868–78. doi:10.1002/hep.24451.PubMedCrossRef

Mulcahy MF, Lewandowski RJ, Ibrahim SM, et al. Radioembolization of colorectal hepatic metastases using yttrium-90 microspheres. Cancer. 2009;115:1849–58. doi:10.1002/cncr.24224.PubMedCrossRef

Rhee TK, Lewandowski RJ, Liu DM, et al. 90Y radioembolization for metastatic neuroendocrine liver tumors: preliminary results from a multi-institutional experience. Ann Surg. 2008;247:1029–35. doi:10.1097/SLA.0b013e3181728a4500000658-200806000-00017.PubMedCrossRef

Kennedy AS, Coldwell D, Nutting C, et al. Resin 90Y-microsphere brachytherapy for unresectable colorectal liver metastases: modern USA experience. Int J Radiat Oncol Biol Phys. 2006;65:412–25. doi:10.1016/j.ijrobp.2005.12.051.PubMedCrossRef

Ahmadzadehfar H, Biersack HJ, Ezziddin S. Radioembolization of liver tumors with yttrium-90 microspheres. Semin Nucl Med. 2010;40:105–21. doi:10.1053/j.semnuclmed.2009.11.001.PubMedCrossRef

Gaba RC, Lewandowski RJ, Kulik LM, et al. Radiation lobectomy: preliminary findings of hepatic volumetric response to lobar yttrium-90 radioembolization. Ann Surg Oncol. 2009;16:1587–96. doi:10.1245/s10434-009-0454-0.PubMedCrossRef

Seidensticker R, Seidensticker M, Damm R, et al. Hepatic toxicity after radioembolization of the liver using (90)Y-microspheres: sequential lobar versus whole liver approach. Cardiovasc Intervent Radiol. 2012;35:1109–18. doi:10.1007/s00270-011-0295-7.PubMedCrossRef

10.

Gulec SA, Pennington K, Hall M, Fong Y. Preoperative Y-90 microsphere selective internal radiation treatment for tumor downsizing and future liver remnant recruitment: a novel approach to improving the safety of major hepatic resections. World J Surg Oncol. 2009;7:6. doi:10.1186/1477-7819-7-6.PubMedCrossRef

11.

Jakobs TF, Saleem S, Atassi B, et al. Fibrosis, portal hypertension, and hepatic volume changes induced by intra-arterial radiotherapy with 90yttrium microspheres. Dig Dis Sci. 2008;53:2556–63. doi:10.1007/s10620-007-0148-z.PubMedCrossRef

12.

Sabet A, Ahmadzadehfar H, Muckle M, et al. Significance of oral administration of sodium perchlorate in planning liver-directed radioembolization. J Nucl Med. 2011;52:1063–7. doi:10.2967/jnumed.110.083626.PubMedCrossRef

13.

Ahmadzadehfar H, Sabet A, Biermann K, et al. The significance of 99mTc-MAA SPECT/CT liver perfusion imaging in treatment planning for 90Y-microsphere selective internal radiation treatment. J Nucl Med. 2010;51:1206–12. doi:10.2967/jnumed.109.074559.PubMedCrossRef

14.

Ahmadzadehfar H, Mohlenbruch M, Sabet A, et al. Is prophylactic embolization of the hepatic falciform artery needed before radioembolization in patients with (99m)Tc-MAA accumulation in the anterior abdominal wall? Eur J Nucl Med Mol Imaging. 2011;38:1477–84. doi:10.1007/s00259-011-1807-z.PubMedCrossRef

15.

Ahmadzadehfar H, Muckle M, Sabet A, Wilhelm K, Kuhl C, Biermann K. The significance of bremsstrahlung SPECT/CT after yttrium-90 radioembolization treatment in the prediction of extrahepatic side effects. Eur J Nucl Med Mol Imaging. 2012;39:309–15. doi:10.1007/s00259-011-1940-8.CrossRef

16.

Wahl RL, Jacene H, Kasamon Y, Lodge MA. From RECIST to PERCIST: evolving considerations for PET response criteria in solid tumors. J Nucl Med. 2009;50 Suppl 1:122S–50. doi:10.2967/jnumed.108.057307.PubMedCrossRef

17.

Eisenhauer EA, Therasse P, Bogaerts J, et al. New response evaluation criteria in solid tumours: revised RECIST guideline (version 1.1). Eur J Cancer. 2009;45:228–47. doi:10.1016/j.ejca.2008.10.026.PubMedCrossRef

18.

Trotti A, Colevas AD, Setser A, et al. CTCAE v3.0: development of a comprehensive grading system for the adverse effects of cancer treatment. Semin Radiat Oncol. 2003;13:176–81. doi:10.1016/S1053-4296(03)00031-6.PubMedCrossRef

19.

Denys A, Prior J, Bize P, Duran R, De Baere T, Halkic N, et al. Portal vein embolization: what do we know? Cardiovasc Intervent Radiol. 2012;35:999–1008. doi:10.1007/s00270-011-0300-1.PubMedCrossRef

20.

Choti MA, Sitzmann JV, Tiburi MF, et al. Trends in long-term survival following liver resection for hepatic colorectal metastases. Ann Surg. 2002;235:759–66.PubMedCrossRef

21.

Sarmiento JM, Heywood G, Rubin J, Ilstrup DM, Nagorney DM, Que FG. Surgical treatment of neuroendocrine metastases to the liver: a plea for resection to increase survival. J Am Coll Surg. 2003;197:29–37. doi:10.1016/S1072-7515(03)00230-8.PubMedCrossRef

22.

Howlader M, Heaton N, Rela M. Resection of liver metastases from breast cancer: towards a management guideline. Int J Surg. 2011;9:285–91. doi:10.1016/j.ijsu.2011.01.009.PubMedCrossRef

23.

Anaya DA, Blazer DG, Abdalla EK. Strategies for resection using portal vein embolization: hepatocellular carcinoma and hilar cholangiocarcinoma. Semin Intervent Radiol. 2008;25:110–22. doi:10.1055/s-2008-1076684.PubMedCrossRef

24.

Sturesson C, Keussen I, Tranberg KG. Prolonged chemotherapy impairs liver regeneration after portal vein occlusion – an audit of 26 patients. Eur J Surg Oncol. 2010;36:358–64. doi:10.1016/j.ejso.2009.12.001.PubMedCrossRef

25.

Covey AM, Brown KT, Jarnagin WR, et al. Combined portal vein embolization and neoadjuvant chemotherapy as a treatment strategy for resectable hepatic colorectal metastases. Ann Surg. 2008;247:451–5. doi:10.1097/SLA.0b013e31815ed693.PubMedCrossRef

26.

Zorzi D, Chun YS, Madoff DC, Abdalla EK, Vauthey JN. Chemotherapy with bevacizumab does not affect liver regeneration after portal vein embolization in the treatment of colorectal liver metastases. Ann Surg Oncol. 2008;15:2765–72. doi:10.1245/s10434-008-0035-7.PubMedCrossRef

27.

Beal IK, Anthony S, Papadopoulou A, et al. Portal vein embolisation prior to hepatic resection for colorectal liver metastases and the effects of periprocedure chemotherapy. Br J Radiol. 2006;79:473–8. doi:10.1259/bjr/29855825.PubMedCrossRef

28.

Tellez C, Benson 3rd AB, Lyster MT, et al. Phase II trial of chemoembolization for the treatment of metastatic colorectal carcinoma to the liver and review of the literature. Cancer. 1998;82:1250–9.PubMedCrossRef

29.

Vogl TJ, Zangos S, Balzer JO, Thalhammer A, Mack MG. Transarterial chemoembolization of liver metastases: indication, technique, results. Rofo. 2002;174:675–83. doi:10.1055/s-2002-32228.PubMedCrossRef

30.

Salem R, Lewandowski RJ, Kulik L, Wang E, Riaz A, Ryu RK. Radioembolization results in longer time-to-progression and reduced toxicity compared with chemoembolization in patients with hepatocellular carcinoma. Gastroenterology. 2011;140:497–507. doi:10.1053/j.gastro.2010.10.049.PubMedCrossRef

31.

Lewandowski RJ, Kulik LM, Riaz A, et al. A comparative analysis of transarterial downstaging for hepatocellular carcinoma: chemoembolization versus radioembolization. Am J Transplant. 2009;9:1920–8. doi:10.1111/j.1600-6143.2009.02695.x.PubMedCrossRef

32.

Vogl TJ, Mack MG, Balzer JO, et al. Liver metastases: neoadjuvant downsizing with transarterial chemoembolization before laser-induced thermotherapy. Radiology. 2003;229:457–64. doi:10.1148/radiol.2292021329.PubMedCrossRef

33.

Nosher JL, Ohman-Strickland PA, Jabbour S, Narra V, Nosher B. Changes in liver and spleen volumes and liver function after radioembolization with yttrium-90 resin microspheres. J Vasc Interv Radiol. 2011;22:1706–13. doi:10.1016/j.jvir.2011.08.017.PubMedCrossRef

34.

Paprottka PM, Schmidt GP, Trumm CG, Hoffmann RT, Reiser MF, Jakobs TF. Changes in normal liver and spleen volume after radioembolization with (90)Y-resin microspheres in metastatic breast cancer patients: findings and clinical significance. Cardiovasc Intervent Radiol. 2011;34:964–72. doi:10.1007/s00270-011-0217-8.PubMedCrossRef

Titel: Hepatic volume changes induced by radioembolization with 90Y resin microspheres. A single-centre study
verfasst von: Hojjat Ahmadzadehfar
Carsten Meyer
Samer Ezziddin
Amir Sabet
Anja Hoff-Meyer
Marianne Muckle
Timur Logvinski
Hans Heinz Schild
Hans Jürgen Biersack
Kai Wilhelm
Publikationsdatum: 01.01.2013
Verlag: Springer-Verlag
Erschienen in: European Journal of Nuclear Medicine and Molecular Imaging / Ausgabe 1/2013
Print ISSN: 1619-7070
Elektronische ISSN: 1619-7089
DOI: https://doi.org/10.1007/s00259-012-2253-2

Springer Medizin

Abstract

Purpose

Methods

Results

Conclusion

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