Lung Mean Dose Prediction in Transarterial Radioembolization (TARE): Superiority of [166Ho]-Scout Over [99mTc]MAA in a Prospective Cohort Study

Purpose Radiation pneumonitis is a serious complication of radioembolization. In holmium-166 ([ 166 Ho]) radioembolization, the lung mean dose (LMD) can be estimated (eLMD) using a scout dose with either technetium-99 m-macroaggregated albumin ([ 99m Tc]MAA) or [ 166 Ho]-microspheres. The accuracy o...

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Published in:Cardiovascular and interventional radiology 2024-04, Vol.47 (4), p.443-450
Main Authors: Wagemans, Martijn E. H. M., Braat, Arthur J. A. T., van Rooij, Rob, Smits, Maarten L. J., Bruijnen, Rutger C. G., Prince, Jip F., Bol, Guus M., de Jong, Hugo W. A. M., Lam, Marnix G. E. H.
Format: Article
Language:English
Subjects:
Cardiology
Clinical Investigation
Correlation coefficient
Correlation coefficients
Drug dosages
Holmium
Imaging
Interventional Oncology
Lungs
Medicine
Medicine & Public Health
Metastases
Microspheres
NCT
NCT01031784
NCT01612325
Nuclear Medicine
Patients
Pneumonitis
Radiation
Radiology
Rank tests
Single photon emission computed tomography
Technetium
Technetium isotopes
Ultrasound
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Summary:Purpose Radiation pneumonitis is a serious complication of radioembolization. In holmium-166 ([ 166 Ho]) radioembolization, the lung mean dose (LMD) can be estimated (eLMD) using a scout dose with either technetium-99 m-macroaggregated albumin ([ 99m Tc]MAA) or [ 166 Ho]-microspheres. The accuracy of eLMD based on [ 99m Tc]MAA (eLMD MAA ) was compared to eLMD based on [ 166 Ho]-scout dose (eLMD Ho-scout ) in two prospective clinical studies. Materials and Methods Patients were included if they received both scout doses ([ 99m Tc]MAA and [ 166 Ho]-scout), had a posttreatment [ 166 Ho]-SPECT/CT (gold standard) and were scanned on the same hybrid SPECT/CT system. The correlation between eLMD MAA /eLMD Ho-scout and LMD Ho-treatment was assessed by Spearman’s rank correlation coefficient ( r ). Wilcoxon signed rank test was used to analyze paired data. Results Thirty-seven patients with unresectable liver metastases were included. During follow-up, none developed symptoms of radiation pneumonitis. Median eLMD MAA (1.53 Gy, range 0.09–21.33 Gy) was significantly higher than median LMD Ho-treatment (0.00 Gy, range 0.00–1.20 Gy; p   0.05). In all cases, eLMD MAA was higher than LMD Ho-treatment ( p  
ISSN:0174-1551
1432-086X
DOI:10.1007/s00270-023-03656-y