Allimant Carole, Deshayes Emmanuel, Kafrouni Marilyne, Santoro Lore, de Verbizier Delphine, Fourcade Marjolaine, Cassinotto Christophe, Hermida Margaux, Guillot Chloé, Mariano-Goulart Denis, Guiu Boris
Department of Radiology, St-Eloi University Hospital, 34000 Montpellier, France.
Department of Nuclear Medicine, Institut du Cancer Montpellier, 34000 Montpellier, France.
Diagnostics (Basel). 2021 May 21;11(6):931. doi: 10.3390/diagnostics11060931.
The functional changes that occur over time in the liver following Y-radioembolization (RE) using personalized dosimetry (PD) remain to be investigated.
November 2016-October 2019: we retrospectively included hepatocellular carcinoma (HCC) patients treated by Y-glass RE using PD, who underwent hepatobiliary scintigraphy (HBS) at baseline and at 15 days, 1, 2, 3, and 6 months after RE.
There were 16 patients with unilobar disease (100%) included, and 64 HBS were performed. Whole liver function significantly decreased over time. The loss was maximal at 2 weeks: -32% ( = 0.002) and remained below baseline at 1 (-15%; = 0.002), 2 (-25%; < 0.001), and 3 months (-16%; = 0.027). No radioembolization-induced liver disease was observed. Treated liver function strongly decreased to reach -64% ( < 0.001) at 2 months. Nontreated liver function decreased at 2 weeks (-21%; = 0.027) and remained below baseline before reaching +20% ( = 0.002) and +59% ( < 0.001) at 3 and 6 months, respectively. Volumetric and functional changes exhibited parallel evolutions in the treated livers ( = 0.01) but independent evolutions in the nontreated livers ( = 0.08).
RE using PD induces significant regional changes in liver function over time. As early as 15 days following RE, both the treated and nontreated livers showed a decreased function. Nontreated liver function recovered after 3 months and greatly increased afterwards.
使用个体化剂量测定法（PD）进行钇-90放射性栓塞术（RE）后，肝脏随时间发生的功能变化仍有待研究。
2016年11月至2019年10月：我们回顾性纳入了接受PD钇-90玻璃微球RE治疗的肝细胞癌（HCC）患者，这些患者在基线时以及RE后15天、1、2、3和6个月接受了肝胆闪烁显像（HBS）。
纳入16例单叶病变患者（100%），共进行了64次HBS检查。全肝功能随时间显著下降。在2周时下降幅度最大：-32%（P = 0.002），在1个月时仍低于基线水平（-15%；P = 0.002），2个月时为-25%（P < 0.001），3个月时为-16%（P = 0.027）。未观察到放射性栓塞诱导的肝病。治疗侧肝功能在2个月时大幅下降至-64%（P < 0.001）。未治疗侧肝功能在2周时下降（-21%；P = 0.027），在3个月和6个月分别达到高于基线水平+20%（P = 0.002）和+59%（P < 0.001）之前一直低于基线水平。在治疗侧肝脏中，体积和功能变化呈现平行演变（P = 0.01），而在未治疗侧肝脏中则呈现独立演变（P = 0.08）。
使用PD的RE随时间推移会引起肝脏功能的显著区域变化。早在RE后15天，治疗侧和未治疗侧肝脏的功能均出现下降。未治疗侧肝功能在3个月后恢复，随后大幅上升。
