Thanh bên bài viết

PDF
Ngày xuất bản: 08/07/2022
Ngày xuất bản Online: 08/07/2022
Số lượt xem tóm tắt: 122
Số lượt xem PDF: 31
DOI: https://doi.org/10.55046/vjrnm.01.71.2021
Số xuất bản
Số 01 (2021)
Chuyên mục
Nghiên cứu khoa học
Trích dẫn bài báo
Mai Hong Son, Le Quoc Khanh, Nguyen Thi , P., Nguyen Thi , N., Nguyen Thanh Huong, Le Duy, . H., & Le Ngoc , H. (2022). 99mTc-maa spect/ct imaging for treatment response prediction after 90Y-radioembolization in HCC patients: comparison with post-treatment 90Y PET/CT. Tạp chí Điện quang & Y học hạt nhân Việt Nam, 01, 38 - 45. https://doi.org/10.55046/vjrnm.01.71.2021

99mTc-maa spect/ct imaging for treatment response prediction after 90Y-radioembolization in HCC patients: comparison with post-treatment 90Y PET/CT

Mai Hong Son, Le Quoc Khanh, Nguyen Thi Phương, Nguyen Thi Nhung, Nguyen Thanh Huong, Le Duy Hung, Le Ngoc Ha

Nội dung chính của bài viết

Tóm tắt

90Y PET/CT imaging is performed after radioembolization to re-evaluate the resin microsphere distribution and estimate the absorbed radiation dose of target tumor. However, the distribution of 90Y resin microsphere on PET/CT was different from that of 99mTc-MAA simulation and additive role of PET/CT was not well established until now. The purpose of our
study is to validate the utility of 90Y PET/CT compared to SPECT/CT simulation in dosimetry and prediction of treatment response.
Material and method: Thirty-four consecutive HCC patients, intermediate and advanced stage who underwent 90Y resin microsphere transarterial embolization (TARE) were recruited in the study. Lung shunt fraction (LSF), tumor to-normal liver uptake ratio (TNr) and absorbed dose for target tumors were estimated on 99m Tc-MAA SPECT/CT and 90Y PET/CT. The patients were followed up after treatment within 3 months (2.8 mo ± 0.84) on contrast- enhanced CT to assess treatment response using
mRECIST criteria.
Results: The imaging characteristics of thrombosis uptake was better delineated on PET/CT imaging than SPECT/CT. The agreement and correlation of TNr on PET/CT and SPECT/CT were stronger. Dose delivery to tumor (Dtumor) threshold of 125 Gy estimated on 99mTc-MAA SPECT/CT was more accurate than PET/CT for prediction of treatment response after 90Y- adioembolization in HCC patients with sensitivity of 87.5% and specificity of 90%.
Conclusions: 99mTc-MAA SPECT/CT is superior to PET/CT to predict treatment response after 90Y resin microsphere treatment.

Chi tiết bài viết

Tài liệu tham khảo

1. Zhu RX, Seto W-K, Lai C-L, Yuen M-F. Epidemiology of Hepatocellular Carcinoma in the Asia-Pacific Region. Gut and liver. 2016;10(3):332-9.
2. 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(8):1206-12.
3. Giammarile F, Bodei L, Chiesa C, Flux G, Forrer F, Kraeber-Bodere F, 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. 2011;38(7):1393-406.
4. Gil‐Alzugaray B, Chopitea A, Iñarrairaegui M, Bilbao JI, Rodriguez‐Fraile M, Rodriguez J, et al. Prognostic factors and prevention of radioembolization‐induced liver disease. Hepatology (Baltimore, Md). 2013;57(3):1078-87.
5. Gates VL, Esmail AA, Marshall K, Spies S, Salem R. Internal pair production of 90Y permits hepatic localization of microspheres using routine PET: proof of concept. J Nucl Med. 2011;52(1):72-6.
6. Kim MN, Kim BK, Han KH, Kim SU. Evolution from WHO to EASL and mRECIST for hepatocellular carcinoma: considerations for tumor response assessment. Expert Rev Gastroenterol Hepatol. 2015;9(3):335-48.
7. Lenoir L, Edeline J, Rolland Y, Pracht M, Raoul J-L, Ardisson V, et al. Usefulness and pitfalls of MAA SPECT/CT in identifying digestive extrahepatic uptake when planning liver radioembolization. European Journal of Nuclear Medicine and Molecular Imaging. 2012;39(5):872-80.
8. Garin E, Lenoir L, Rolland Y, Laffont S, Pracht M, Mesbah H, et al. Effectiveness of quantitative MAA SPECT/CT for the definition of vascularized hepatic volume and dosimetric approach: phantom validation and clinical preliminary results in patients with complex hepatic vascularization treated with yttrium-90-labeled microspheres. Nucl Med Commun. 2011;32(12):1245-55.
9. Garin E, Rolland Y, Laffont S, Edeline J. Clinical impact of (99m)Tc-MAA SPECT/CT-based dosimetry in the radioembolization of liver malignancies with (90)Y-loaded microspheres. European Journal of Nuclear Medicine and Molecular Imaging. 2016;43:559-75.
10. Garin E, Rolland Y, Pracht M, Le Sourd S, Laffont S, Mesbah H, et al. High impact of macroaggregated albumin-based tumour dose on response and overall survival in hepatocellular carcinoma patients treated with 90Y-loaded glass microsphere radioembolization. 2017;37(1):101-10.
11. Kao YH, Hock Tan AE, Burgmans MC, Irani FG, Khoo LS, Gong Lo RH, 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.