Holmium-166 radioembolisation dosimetry in HCC.
Biodistribution
Dosimetry
Hepatocellular carcinoma
Holmium
Personalised treatment planning
Radioembolisation
Journal
European journal of nuclear medicine and molecular imaging
ISSN: 1619-7089
Titre abrégé: Eur J Nucl Med Mol Imaging
Pays: Germany
ID NLM: 101140988
Informations de publication
Date de publication:
29 Oct 2024
29 Oct 2024
Historique:
received:
07
07
2024
accepted:
29
09
2024
medline:
29
10
2024
pubmed:
29
10
2024
entrez:
29
10
2024
Statut:
aheadofprint
Résumé
To evaluate dosimetry, dose-response and dose-toxicity relationships for holmium-166 ( Thirty-one patients with hepatocellular carcinoma were included in the HEPAR Primary study (NCT03379844, registered on December 20th, 2017) and underwent Median tumour absorbed dose (tumour level) was 95.5 Gy (range 44-332 Gy). Median non-tumour absorbed dose based on whole liver volume was 19 Gy (range 3 - 48 Gy) and based on target liver volume was 30 Gy (range 13 - 54 Gy). There was a significant association between non-tumour absorbed dose and toxicity. Tumours with partial response/complete response (PR/CR, responders) received a 41% higher absorbed dose than tumours with progressive disease/stable disease (PD/SD, non-responders) (95%CI: 2%-93%, p = 0.04). A predictive value of 90% for tumour response was observed at a tumour absorbed dose threshold of 155 Gy, 100% predictive value was achieved at 184.5 Gy. This study confirms a positive relationship between tumour absorbed dose and response and between non-tumour absorbed dose and toxicity. Dose thresholds found in this study can serve as a basis for personalized dosimetry in HCC patients treated with
Identifiants
pubmed: 39470786
doi: 10.1007/s00259-024-06940-2
pii: 10.1007/s00259-024-06940-2
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Subventions
Organisme : KWF Kankerbestrijding
ID : P10307
Informations de copyright
© 2024. The Author(s).
Références
Smits MLJ, Dassen MG, Prince JF, Braat A, Beijst C, Bruijnen RCG, et al. The superior predictive value of (166)Ho-scout compared with (99m)Tc-macroaggregated albumin prior to (166)Ho-microspheres radioembolization in patients with liver metastases. Eur J Nucl Med Mol Imaging. 2019. https://doi.org/10.1007/s00259-019-04460-y .
doi: 10.1007/s00259-019-04460-y
pubmed: 31399801
pmcid: 7075844
Smits MLJ, Nijsen JFW, van den Bosch MAAJ, Lam MGEH, Vente MAD, Mali WPTM, et al. Holmium-166 radioembolisation in patients with unresectable, chemorefractory liver metastases (HEPAR trial): a phase 1, dose-escalation study. Lancet Oncol. 2012;13:1025–34. https://doi.org/10.1016/s1470-2045(12)70334-0 .
doi: 10.1016/s1470-2045(12)70334-0
pubmed: 22920685
Garin E, Tselikas L, Guiu B, Chalaye J, Edeline J, de Baere T, et al. Personalised versus standard dosimetry approach of selective internal radiation therapy in patients with locally advanced hepatocellular carcinoma (DOSISPHERE-01): a randomised, multicentre, open-label phase 2 trial. Lancet Gastroenterol Hepatol. 2021;6:17–29. https://doi.org/10.1016/s2468-1253(20)30290-9 .
doi: 10.1016/s2468-1253(20)30290-9
pubmed: 33166497
van Roekel C, Bastiaannet R, Smits MLJ, Bruijnen RC, Braat A, de Jong H, et al. Dose-Effect Relationships of (166)Ho Radioembolization in Colorectal Cancer. J Nucl Med. 2021;62:272–9. https://doi.org/10.2967/jnumed.120.243832 .
doi: 10.2967/jnumed.120.243832
pubmed: 32591491
Alsultan AA, van Roekel C, Barentsz MW, Smits MLJ, Kunnen B, Koopman M, et al. Dose-response and dose-toxicity relationships for yttrium-90 glass radioembolization in patients with colorectal cancer liver metastases. J Nucl Med. 2021. https://doi.org/10.2967/jnumed.120.255745 .
doi: 10.2967/jnumed.120.255745
pubmed: 33741643
pmcid: 8612342
Reinders MTM, van Erpecum KJ, Smits MLJ, Braat A, de Bruijne J, Bruijnen RCG, et al. Safety and efficacy of holmium-166 radioembolization in hepatocellular carcinoma - the HEPAR Primary study. J Nucl Med. 2022. https://doi.org/10.2967/jnumed.122.263823 .
doi: 10.2967/jnumed.122.263823
pubmed: 35589409
pmcid: 9730925
Lencioni R, Llovet JM. Modified RECIST (mRECIST) assessment for hepatocellular carcinoma. Semin Liver Dis. 2010;30:52–60. https://doi.org/10.1055/s-0030-1247132 .
doi: 10.1055/s-0030-1247132
pubmed: 20175033
Heimbach JK, Kulik LM, Finn RS, Sirlin CB, Abecassis MM, Roberts LR, et al. AASLD guidelines for the treatment of hepatocellular carcinoma. Hepatology. 2018;67:358–80. https://doi.org/10.1002/hep.29086 .
doi: 10.1002/hep.29086
pubmed: 28130846
Garin E, Rolland Y, Edeline J. (90)Y-loaded microsphere SIRT of HCC patients with portal vein thrombosis: high clinical impact of 99mTc-MAA SPECT/CT-based dosimetry. Semin Nucl Med. 2019;49:218–26. https://doi.org/10.1053/j.semnuclmed.2019.01.006 .
doi: 10.1053/j.semnuclmed.2019.01.006
pubmed: 30954188
Bastiaannet R, Kappadath SC, Kunnen B, Braat A, Lam M, de Jong H. The physics of radioembolization. EJNMMI Phys. 2018;5:22. https://doi.org/10.1186/s40658-018-0221-z .
doi: 10.1186/s40658-018-0221-z
pubmed: 30386924
pmcid: 6212377
van Rooij R, Braat AJAT, de Jong HWAM, Lam MGEH. Simultaneous 166Ho/99mTc dual-isotope SPECT with Monte Carlo-based downscatter correction for automatic liver dosimetry in radioembolization. EJNMMI Physics. 2020;7:13. https://doi.org/10.1186/s40658-020-0280-9 .
doi: 10.1186/s40658-020-0280-9
pubmed: 32130539
pmcid: 7056760
Obuchowski NA. Nonparametric analysis of clustered ROC curve data. Biometrics. 1997;53:567–78.
doi: 10.2307/2533958
pubmed: 9192452
Heinze G, Dunkler D. Avoiding infinite estimates of time-dependent effects in small-sample survival studies. Stat Med. 2008;27:6455–69. https://doi.org/10.1002/sim.3418 .
doi: 10.1002/sim.3418
pubmed: 18816502
Weber M, Lam M, Chiesa C, Konijnenberg M, Cremonesi M, Flamen P, et al. EANM procedure guideline for the treatment of liver cancer and liver metastases with intra-arterial radioactive compounds. Eur J Nucl Med Mol Imaging. 2022;49:1682–99. https://doi.org/10.1007/s00259-021-05600-z .
doi: 10.1007/s00259-021-05600-z
pubmed: 35146577
pmcid: 8940802
van de Maat GH, Seevinck PR, Elschot M, Smits ML, de Leeuw H, van Het Schip AD, et al. MRI-based biodistribution assessment of holmium-166 poly(L-lactic acid) microspheres after radioembolisation. Eur Radiol. 2013;23:827–35. https://doi.org/10.1007/s00330-012-2648-2 .
doi: 10.1007/s00330-012-2648-2
pubmed: 23014797
Willowson KP, Tapner M, Bailey DL. A multicentre comparison of quantitative (90)Y PET/CT for dosimetric purposes after radioembolization with resin microspheres : The QUEST Phantom Study. Eur J Nucl Med Mol Imaging. 2015;42:1202–22. https://doi.org/10.1007/s00259-015-3059-9 .
doi: 10.1007/s00259-015-3059-9
pubmed: 25967868
pmcid: 4480824
Ahmadzadehfar H, Sabet A, Biermann K, Muckle M, Brockmann H, Kuhl C, 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. https://doi.org/10.2967/jnumed.109.074559 .
doi: 10.2967/jnumed.109.074559
pubmed: 20660379
Elschot M, Nijsen JFW, Lam MGEH, Smits MLJ, Prince JF, Viergever MA, et al. (⁹⁹m)Tc-MAA overestimates the absorbed dose to the lungs in radioembolization: a quantitative evaluation in patients treated with 1⁶⁶Ho-microspheres. Eur J Nucl Med Mol Imaging. 2014;41:1965–75. https://doi.org/10.1007/s00259-014-2784-9 .
doi: 10.1007/s00259-014-2784-9
pubmed: 24819055
Pasciak AS, Abiola G, Liddell RP, Crookston N, Besharati S, Donahue D, et al. The number of microspheres in Y90 radioembolization directly affects normal tissue radiation exposure. Eur J Nucl Med Mol Imaging. 2020;47:816–27. https://doi.org/10.1007/s00259-019-04588-x .
doi: 10.1007/s00259-019-04588-x
pubmed: 31741021
Sirtex. Sirtex FLEXdose Delivery Program. Australia: MIM Software; 2021. https://www.sirtex.com/media/cntobgwe/flexdose-delivery-programme-brochure-emea-apm-emea-012-07-20-v4.pdf . Accessed 10 Jun 2024.
Roosen J, Klaassen NJM, Westlund Gotby LEL, Overduin CG, Verheij M, Konijnenberg MW, et al. To 1000 Gy and back again: a systematic review on dose-response evaluation in selective internal radiation therapy for primary and secondary liver cancer. Eur J Nucl Med Mol Imaging. 2021;48:3776–90. https://doi.org/10.1007/s00259-021-05340-0 .
doi: 10.1007/s00259-021-05340-0
pubmed: 33839892
pmcid: 8484215