Department of Diagnostic and Interventional Radiology, RWTH Aachen University Hospital, Aachen, Germany.
Department of Diagnostic and Interventional Radiology, RWTH Aachen University Hospital, Aachen, Germany.
J Vasc Interv Radiol. 2021 Jun;32(6):836-842.e2. doi: 10.1016/j.jvir.2021.01.281. Epub 2021 Mar 6.
To compare hepatic hypertrophy in the contralateral lobe achieved by unilobar transarterial radioembolization (TARE) versus portal vein embolization (PVE) in a swine model.
After an escalation study to determine the optimum dose to achieve hypertrophy after unilobar TARE in 4 animals, 16 pigs were treated by TARE (yttrium-90 resin microspheres) or PVE (lipiodol/n-butyl cyanoacrylate). Liver volume was calculated based on CT before treatment and during 6 months of follow-up. Independent t-test (P < .05) was used to compare hypertrophy. The relationship between hypertrophy after TARE and absorbed dose was calculated using the Pearson correlation.
At 2 and 4 weeks after treatment, a significantly higher degree of future liver remnant hypertrophy was observed in the PVE group versus the TARE group, with a median volume gain of 31% (interquartile range [IQR]: 16%-66%) for PVE versus 23% (IQR: 6%-36%) for TARE after 2 weeks and 51% (IQR: 47%-69%) for PVE versus 29% (IQR: 20%-50%) for TARE after 4 weeks. After 3 and 6 months, hypertrophy converged without a statistically significant difference, with a volume gain of 103% (IQR: 86%-119%) for PVE versus 82% (IQR: 70%-96%) for TARE after 3 months and 115% (IQR: 70%-46%) for PVE versus 86% (IQR: 58%-111%) for TARE after 6 months. A strong correlation was observed between radiation dose (median 162 Gy, IQR: 139-175) and hypertrophy.
PVE resulted in rapid hypertrophy within 1 month of the procedure, followed by a plateau, whereas TARE resulted in comparable hypertrophy by 3-6 months. TARE-induced hypertrophy correlated with radiation absorbed dose.
比较猪模型中单侧经肝动脉放射性栓塞术（TARE）与门静脉栓塞术（PVE）引起的对侧肝叶肝肥大。
在 4 只动物中进行了一项递增研究，以确定进行单侧 TARE 后实现肥大的最佳剂量，然后对 16 只猪进行 TARE（钇-90 树脂微球）或 PVE（碘油/正丁基氰基丙烯酸酯）治疗。根据治疗前和 6 个月随访期间的 CT 计算肝体积。采用独立 t 检验（P<.05）比较肥大程度。使用 Pearson 相关性计算 TARE 后肥大与吸收剂量之间的关系。
治疗后 2 周和 4 周时，PVE 组与 TARE 组相比，未来肝残留的肥大程度明显更高，PVE 组的中位体积增加率为 31%（四分位距[IQR]：16%-66%），TARE 组为 23%（IQR：6%-36%），PVE 组为 51%（IQR：47%-69%），TARE 组为 29%（IQR：20%-50%）。在 3 个月和 6 个月时，没有统计学差异，PVE 组的体积增加率为 103%（IQR：86%-119%），TARE 组为 82%（IQR：70%-96%），PVE 组为 115%（IQR：70%-46%），TARE 组为 86%（IQR：58%-111%）。观察到辐射剂量（中位数 162 Gy，IQR：139-175）与肥大之间存在很强的相关性。
PVE 在手术 1 个月内迅速引起肥大，随后达到平台期，而 TARE 在 3-6 个月内引起相似的肥大。TARE 引起的肥大与吸收剂量相关。
