Radioembolization with 90Y glass microspheres for hepatocellular carcinoma: significance of pretreatment 11C-acetate and 18F-FDG PET/CT and posttreatment 90Y PET/CT in individualized dose prescription

Purpose The aim of this study was to establish an algorithm for the prescription of 90 Y glass microsphere radioembolization ( 90 Y-GMRE) of HCC in individual patients based on the relationship between tumour dose (TD) and response validated by 90 Y PET/CT dosimetry and dual-tracer PET/CT metabolic...

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Published in:European journal of nuclear medicine and molecular imaging 2018-11, Vol.45 (12), p.2110-2121
Main Authors: Ho, Chi Lai, Chen, Sirong, Cheung, Shing Kee, Leung, Yim Lung, Cheng, Kam Chau, Wong, Ka Nin, Wong, Yuet Hung, Leung, Thomas Wai Tong
Format: Article
Language:English
Subjects:
Acetic acid
Cardiology
Correlation
Differentiation (biology)
Dosimeters
Dosimetry
Fluorine isotopes
Hepatocellular carcinoma
Imaging
Liver
Liver cancer
Medicine
Medicine & Public Health
Microspheres
Nuclear Medicine
Oncology
Original Article
Orthopedics
Parameters
Patients
Positron emission tomography
Radiology
Radiosensitivity
Sensitivity
Single photon emission computed tomography
Thresholds
Tumors
Yttrium isotopes
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Summary:Purpose The aim of this study was to establish an algorithm for the prescription of 90 Y glass microsphere radioembolization ( 90 Y-GMRE) of HCC in individual patients based on the relationship between tumour dose (TD) and response validated by 90 Y PET/CT dosimetry and dual-tracer PET/CT metabolic parameters. Methods The study group comprised 62 HCC patients prospectively recruited for 90 Y-GMRE who underwent pretreatment dual-tracer ( 11 C-acetate and 18 F-FDG) PET/CT as surrogate markers of HCC cellular differentiation. Pretreatment tumour-to-nontumour ratio on 99m Tc-MAA SPECT/CT (T/NT MAA ) was correlated with posttreatment 90 Y PET/CT T/NT 90Y after quantification validation. The TD–response relationship for HCC of different tracer groups was assessed on follow-up PET/CT 2 months after treatment. Results 90 Y PET/CT was accurate in the measurement of recovery of injected 90 Y activity (81.9–99.9%, median 94.8%). Pretreatment SPECT/CT T/NT MAA was strongly correlated with posttreatment 90 Y PET/CT T/NT 90Y (5.6 ± 3.2 versus 5.9 ± 3.5, T/NT 90Y 1.01 × T/NT MAA  + 0.161, r  = 0.918, P  
ISSN:1619-7070
1619-7089
DOI:10.1007/s00259-018-4064-6