Liver Function Changes After Technetium-99m-Macroaggregated Albumin Administration and Their Predictive Value Regarding Hepatotoxicity in Patients Undergoing Yttrium-90-Radioembolization.

BACKGROUND/AIM: Intraarterial Technetium-99m-Macroaggregated Albumin (Tc-MAA) administration is an established method to predict particle distribution prior to radioembolization. This study aimed to analyse the impact of intraarterial administration of Tc-MAA on changes in liver-specific laboratory parameters and to assess whether such changes are associated with post-radioembolization hepatotoxicity.

PATIENTS AND METHODS

A total of 202 patients treated with radioembolization received prior mapping angiography with Tc-MAA administration. All patients underwent clinical and laboratory examinations, including liver-specific parameters at certain times before and after mapping angiography/Tc-MAA administration, as well as before radioembolization and during follow-up.

RESULTS

Bilirubin increased temporarily after Tc-MAA administration (p<0.001), but was not clinically relevant, and returned close to the initial value before radioembolization. These changes showed no association with subsequent postradioembolic hepatotoxicity or shortened overall survival.

CONCLUSION

Tc-MAA administration results in a significant, however, not clinically relevant transient increase in bilirubin levels, which does not provide a predictive value for subsequent radioembolization outcome or postradioembolic hepatotoxicity.