Boughdad Sarah, Duran Rafael, Prior John O, da Mota Michael, De Carvalho Mélanie Mendes, Costes Julien, Firsova Maria, Gnesin Silvano, Schaefer Niklaus
Department of Nuclear Medicine and Molecular Imaging, Lausanne University Hospital, Rue du Bugnon 46, 1011, Lausanne, Switzerland.
Department of Radiology, Lausanne University Hospital, Lausanne, Switzerland.
EJNMMI Rep. 2024 Aug 26;8(1):26. doi: 10.1186/s41824-024-00214-8.
Transarterial radio-embolization (TARE) became a routine procedure for non-resectable liver tumor mainly hepatocellular carcinoma (HCC). Personalized dosimetry to the index lesion increased tumor response rate. However, there is no requirement to measure the precise activity injected during TARE. We measured Y-glass microspheres residue (Y-Res) in the application system after TARE and assessed its potential impact on the tumor absorbed dose (AD) previously planned with Tc MAA SPECT/CT.
We measured Y-Res using PET/CT in all patients that underwent TARE using Y-glass-microspheres for non-resectable liver tumors over one year.
Y-Res was measured in 34 patients (HCC n = 22) with 61 injections, 93.1 ± 94.6 MBq [2-437] that was 4.8 ± 3.5% [0.2-13.7] in comparison to the activity measured in the sealed TheraSphere™ vial (ρ = 0.697; p < 0.001).
We reported an average of 5% Y-Res using PET/CT after TARE with the strongest association to the activity in the TheraSphere™ vial. Therefore, when a high Y-Res is suspected on the survey meter, a Y-PET/CT scan of Y-Res might be useful as a first step to estimate if the target lesion received the recommended AD, especially in HCC patients with borderline tumor dosimetry on the pre-treatment Tc-MAA SPECT/CT.
经动脉放射性栓塞术（TARE）已成为不可切除肝脏肿瘤（主要是肝细胞癌，HCC）的常规治疗手段。对靶病灶进行个体化剂量测定可提高肿瘤反应率。然而，TARE过程中无需测量注入的精确活度。我们在TARE后测量了应用系统中的钇玻璃微球残留量（Y-Res），并评估了其对先前通过锝标记大聚合人血清白蛋白（Tc MAA）单光子发射计算机断层扫描/计算机断层扫描（SPECT/CT）计划的肿瘤吸收剂量（AD）的潜在影响。
我们对所有在一年时间内使用钇玻璃微球进行TARE治疗不可切除肝脏肿瘤的患者，采用正电子发射断层扫描/计算机断层扫描（PET/CT）测量Y-Res。
对34例患者（22例为HCC）进行了61次注射的Y-Res测量，其活度为93.1±94.6兆贝可[2 - 437]，与密封的TheraSphere™小瓶中测量的活度相比为4.8±3.5%[0.2 - 13.7]（ρ = 0.697；p < 0.001）。
我们报告了TARE后使用PET/CT测量的Y-Res平均为5%，与TheraSphere™小瓶中的活度相关性最强。因此，当在剂量仪上怀疑有高Y-Res时，Y-Res的Y-PET/CT扫描可能是估计靶病灶是否接受了推荐AD的有用的第一步，特别是在治疗前Tc-MAA SPECT/CT肿瘤剂量测定处于临界值的HCC患者中。
