Division of Interventional Radiology, Department of Radiology and Biomedical Imaging, Yale School of Medicine, New Haven, CT, USA.
Department of Radiology, Medical University of South Caroline, Charleston, SC, USA.
Nucl Med Biol. 2018 Apr;59:22-28. doi: 10.1016/j.nucmedbio.2018.01.001. Epub 2018 Jan 16.
There are two different types of Y Microspheres, glass and resin, in the market for Y radioembolization (Y-RE). This study aimed to investigate the dose of radiation delivered through glass vs. resin-based Y-RE to intrahepatic cholangiocarcinoma (ICC).
In this retrospective study, 10 patients with ICC underwent Y-RE, five underwent glass (Glass group) and other 5 resin (Resin group) microspheres. Technetium-99m macro-aggregated albumin (Tc-99m MAA) shunt study was performed two weeks before Y-RE. Within 2 h from Y-RE, Bremsstrahlung SPECT/CT was obtained. Regions of interest (ROIs) were segmented around the targeted tumor and the liver. Tumor and liver volumes, corresponding radioactive counts, and tumor to liver count ratio were calculated using MIM software and compared between Glass and Resin groups.
Mean hepatopulmonary shunt fraction was 7.1 vs. 6.2% for the Glass and Resin groups (p = 0.83), with no extrahepatic activity. There was no difference in the activity and tumor uptake of administered Tc-99m MAA between both groups (p = 0.71 and p = 0.63). Mean administered activity of Y in the Glass group was higher than the Resin group (73.2 ± 24.3 vs. 44.5 ± 18.2 mCi, p < 0.001). The tumor Y uptake was significantly higher in the Glass group compared to the Resin group (41.3% vs. 33.5%, p < 0.001), corresponding to the mean tumor dose of 205.7 ± 19.7 vs. 128.9 ± 10.6 Gy, respectively (p < 0.001). The tumor to normal liver parenchyma Y dose ratio was significantly higher in the Glass group compared to the Resin group, 4.9 ± 0.7 versus 2.4 ± 0.3 respectably (p < 0.001).
Both Y glass and resin-based microsphere Y-RE are feasible and safe in patients with ICC, while Y glass microsphere delivers higher dose of Y to the targeted tumors.
While both Y glass and resin-based microsphere yttrium-90 radioembolization are feasible and safe treatment options for in patients with intrahepatic cholangiocarcinoma, Y glass microsphere delivers higher dose of Y to the targeted tumors.
Both of Y glass and resin-based microsphere can be safely and feasibly used for treatment of intrahepatic cholangiocarcinoma, difference in dose of Y delivered to the targeted tumors should be clinically considered while choosing the microsphere type.
钇 90 微球（Y 微球）在放射性栓塞治疗中有玻璃和树脂两种不同的类型。本研究旨在探讨玻璃与树脂基 Y 微球在治疗肝内胆管细胞癌（ICC）时所产生的辐射剂量。
本回顾性研究纳入了 10 名 ICC 患者，其中 5 名接受玻璃（玻璃组），5 名接受树脂（树脂组）Y 微球放射性栓塞治疗。在 Y 微球放射性栓塞治疗前两周进行锝 99m 聚合白蛋白（Tc-99m MAA）肝肺分流检查。Y 微球放射性栓塞治疗后 2 小时内，进行 Bremsstrahlung SPECT/CT 检查。使用 MIM 软件在靶向肿瘤和肝脏周围分割感兴趣区（ROI），计算肿瘤和肝脏体积、放射性计数和肿瘤与肝脏计数比，并在玻璃组和树脂组之间进行比较。
玻璃组和树脂组的肝肺分流率分别为 7.1%和 6.2%（p=0.83），无肝外放射性活性。两组之间 Tc-99m MAA 的放射性活性和肿瘤摄取没有差异（p=0.71 和 p=0.63）。玻璃组的 Y 放射性活度高于树脂组（73.2±24.3 比 44.5±18.2mCi，p＜0.001）。玻璃组的肿瘤 Y 摄取明显高于树脂组（41.3%比 33.5%，p＜0.001），相应的肿瘤剂量分别为 205.7±19.7 和 128.9±10.6Gy（p＜0.001）。玻璃组的肿瘤与正常肝实质 Y 剂量比明显高于树脂组，分别为 4.9±0.7 和 2.4±0.3（p＜0.001）。
玻璃和树脂基 Y 微球放射性栓塞治疗 ICC 患者均可行且安全，玻璃基 Y 微球可向靶向肿瘤提供更高剂量的 Y。
玻璃和树脂基 Y 微球放射性栓塞治疗肝内胆管细胞癌均可行且安全，玻璃基 Y 微球向靶向肿瘤提供的 Y 剂量更高。
玻璃和树脂基 Y 微球均可安全、可行地用于治疗肝内胆管细胞癌，在选择微球类型时，应考虑靶向肿瘤的 Y 剂量差异。
