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经动脉放射性栓塞术后即刻使用 micro-CT 和放射自显影对结直肠肝转移灶行 PET/CT 引导下活检标本进行钇-90 活性定量。

Yttrium-90 Activity Quantification in PET/CT-Guided Biopsy Specimens from Colorectal Hepatic Metastases Immediately after Transarterial Radioembolization Using Micro-CT and Autoradiography.

机构信息

Department of Medical Physics, Memorial Sloan Kettering Cancer Center, New York, New York.

Department of Pathology, Memorial Sloan Kettering Cancer Center, New York, New York.

出版信息

J Vasc Interv Radiol. 2023 Sep;34(9):1556-1564.e4. doi: 10.1016/j.jvir.2023.05.022. Epub 2023 May 16.


DOI:10.1016/j.jvir.2023.05.022
PMID:37201655
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11163896/
Abstract

PURPOSE: To evaluate the yttrium-90 (Y) activity distribution in biopsy tissue samples of the treated liver to quantify the dose with higher spatial resolution than positron emission tomography (PET) for accurate investigation of correlations with microscopic biological effects and to evaluate the radiation safety of this procedure. MATERIALS AND METHODS: Eighty-six core biopsy specimens were obtained from 18 colorectal liver metastases (CLMs) immediately after Y transarterial radioembolization (TARE) with either resin or glass microspheres using real-time Y PET/CT guidance in 17 patients. A high-resolution micro-computed tomography (micro-CT) scanner was used to image the microspheres in part of the specimens and allow quantification of Y activity directly or by calibrating autoradiography (ARG) images. The mean doses to the specimens were derived from the measured specimens' activity concentrations and from the PET/CT scan at the location of the biopsy needle tip for all cases. Staff exposures were monitored. RESULTS: The mean measured Y activity concentration in the CLM specimens at time of infusion was 2.4 ± 4.0 MBq/mL. The biopsies revealed higher activity heterogeneity than PET. Radiation exposure to the interventional radiologists during post-TARE biopsy procedures was minimal. CONCLUSIONS: Counting the microspheres and measuring the activity in biopsy specimens obtained after TARE are safe and feasible and can be used to determine the administered activity and its distribution in the treated and biopsied liver tissue with high spatial resolution. Complementing Y PET/CT imaging with this approach promises to yield more accurate direct correlation of histopathological changes and absorbed dose in the examined specimens.

摘要

目的:评估经动脉放射性栓塞术(TARE)治疗后的肝组织活检样本中的钇-90(Y)活性分布,以比正电子发射断层扫描(PET)更高的空间分辨率量化剂量,从而准确研究与微观生物学效应的相关性,并评估该程序的辐射安全性。

材料和方法:在 17 名患者中,使用实时 Y 放射性核素 PET/CT 引导,对 18 个结直肠癌肝转移瘤(CLM)的 86 个核心活检样本进行 Y 放射性核素树脂或玻璃微球 TARE 治疗后立即取样。使用高分辨率微计算机断层扫描(micro-CT)扫描仪对部分样本中的微球进行成像,并允许通过直接量化 Y 活性或校准放射自显影(ARG)图像进行定量。对于所有病例,通过测量样本的活性浓度和活检针尖端位置的 PET/CT 扫描,得出样本的平均剂量。监测工作人员的暴露情况。

结果:输注时 CLM 样本中的平均测量 Y 活性浓度为 2.4±4.0 MBq/mL。活检显示出比 PET 更高的活性异质性。TARE 后活检过程中对介入放射科医生的辐射暴露极小。

结论:在 TARE 后获取的微球计数和活检样本活性测量是安全可行的,可以用于确定放射性核素在治疗和活检肝组织中的给药活性及其分布,具有高空间分辨率。通过这种方法补充 Y PET/CT 成像有望更准确地直接关联检查样本中的组织病理学变化和吸收剂量。

相似文献

[1]
Yttrium-90 Activity Quantification in PET/CT-Guided Biopsy Specimens from Colorectal Hepatic Metastases Immediately after Transarterial Radioembolization Using Micro-CT and Autoradiography.

J Vasc Interv Radiol. 2023-9

[2]
High quality imaging and dosimetry for yttrium-90 (Y) liver radioembolization using a SiPM-based PET/CT scanner.

Eur J Nucl Med Mol Imaging. 2021-7

[3]
Histopathologic Changes after Yttrium-90 Radioembolization of Colorectal Liver Metastases: A Pilot Feasibility Study.

J Vasc Interv Radiol. 2024-7

[4]
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Phys Med Biol. 2020-11-27

[5]
Microsphere localization and dose quantification using positron emission tomography/CT following hepatic intraarterial radioembolization with yttrium-90 in patients with advanced hepatocellular carcinoma.

J Vasc Interv Radiol. 2014-10

[6]
Feasibility of imaging Y microspheres at diagnostic activity levels for hepatic radioembolization treatment planning.

Med Phys. 2020-1-20

[7]
Yttrium-90 Radiation Segmentectomy of Hepatocellular Carcinoma: A Comparative Study of the Effectiveness, Safety, and Dosimetry of Glass-Based versus Resin-Based Microspheres.

J Vasc Interv Radiol. 2023-7

[8]
Comparison of positron emission tomography and bremsstrahlung imaging to detect particle distribution in patients undergoing yttrium-90 radioembolization for large hepatocellular carcinomas or associated portal vein thrombosis.

J Vasc Interv Radiol. 2013-6-20

[9]
Use of dose-volume histograms for metabolic response prediction in hepatocellular carcinoma patients undergoing transarterial radioembolization with Y-90 resin microspheres.

Ann Nucl Med. 2024-7

[10]
Dose-response relationship after yttrium-90-radioembolization with glass microspheres in patients with neuroendocrine tumor liver metastases.

Eur J Nucl Med Mol Imaging. 2022-4

引用本文的文献

[1]
Tumor Absorbed Dose Predicts Survival and Local Tumor Control in Colorectal Liver Metastases Treated with 90Y Radioembolization.

Cardiovasc Intervent Radiol. 2025-9-9

[2]
The relationship between yttrium-90 glass microspheres specific activity, particle density and treatment outcomes in HCC and mCRC.

Eur J Nucl Med Mol Imaging. 2025-5-22

[3]
Technical Note: Impact of impurities on Yttrium-90 glass microsphere activity quantitation.

Med Phys. 2024-3

本文引用的文献

[1]
Survival and Toxicities after Y Transarterial Radioembolization of Metastatic Colorectal Cancer in the RESIN Registry.

Radiology. 2022-10

[2]
SIR-Spheres Activity Measurements Reveal Systematic Miscalibration.

J Nucl Med. 2022-8

[3]
Micro-computed tomography: A novel diagnostic technique for the evaluation of gastrointestinal specimens.

Endosc Int Open. 2021-12-14

[4]
Role of Resin Microsphere Y90 Dosimetry in Predicting Objective Tumor Response, Survival and Treatment Related Toxicity in Surgically Unresectable Colorectal Liver Metastasis: A Retrospective Single Institution Study.

Cancers (Basel). 2021-9-29

[5]
Pathological evaluation of a rectal endoscopic submucosal dissection specimen using micro-computed tomography.

Endoscopy. 2022-6

[6]
ACR-ABS-ACNM-ASTRO-SIR-SNMMI practice parameter for selective internal radiation therapy or radioembolization for treatment of liver malignancies.

Brachytherapy. 2021

[7]
Colon Cancer, Version 2.2021, NCCN Clinical Practice Guidelines in Oncology.

J Natl Compr Canc Netw. 2021-3-2

[8]
Three-Dimensional Vessel Segmentation in Whole-Tissue and Whole-Block Imaging Using a Deep Neural Network: Proof-of-Concept Study.

Am J Pathol. 2021-3

[9]
Detection and assessment of capsular invasion, vascular invasion and lymph node metastasis volume in thyroid carcinoma using microCT scanning of paraffin tissue blocks (3D whole block imaging): a proof of concept.

Mod Pathol. 2020-12

[10]
Tumor Radiation-absorbed Dose: The Missing Link in Radioembolization.

Radiology. 2020-9

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