Reinders Margot T M, Smits Maarten J L, van Erpecum Karel, de Bruijne Joep, Bruijnen Rutger C G, Sprengers Dave, de Man Rob, Vegt Erik, IJzermans Jan N M, Lam Marnix G E H, Braat Arthur J A T
Department of Radiology & Nuclear Medicine, University Medical Center Utrecht, Heidelberglaan 100, Utrecht, 3584 CX, the Netherlands.
Department of Gastroenterology & Hepatology, Utrecht University - University Medical Center Utrecht, P.O. Box 85500 100, Utrecht, 3500 GA, the Netherlands.
EJNMMI Res. 2025 Jan 9;15(1):2. doi: 10.1186/s13550-025-01196-9.
To study the feasibility of hepatobiliary scintigraphy (HBS) to improve selection and planning of patients with hepatocellular carcinoma (HCC) treated with holmium-166 (Ho)-microspheres radioembolization.
Thirty-one patients with HCC were included and treated with Ho- radioembolization as part of a prospective phase 2 study. Twenty-seven patients were eligible for analysis, 67% had a cirrhotic liver morphology on imaging, 70% had multifocal disease and 51% had bilobar disease. None of the patients had clinical signs of liver decompensation (Child Pugh ≤ B7, median MELD 9 or ALBI - 2.55). Global and regional hepatic function was based on manual delineation of HBS using 200 MBq Tc-mebrofenine, acquired during screening and approximately three months after Ho-radioembolization, referred to as liver clearance rate (LCR). In line with LCR at baseline, a significant correlation was found between LCR and lab results, including bilirubin, albumin, ALT, MELD-score, and ALBI-score (p < 0.05) during follow-up. HBS showed a significant decrease in median LCR (-16%; p = 0.0017) and volume (-17%; p = 0.0027) in the treated liver, without a significant increase in the non-treated liver. Median relative change in overall LCR in non-cirrhotics was 0% (range - 23-33%), in cirrhotics - 10% (range - 40 - 19%; p = 0.40).
HBS showed that hepatic function and volume significantly decreased in parts of the liver treated with Ho-microspheres radioembolization in patients with HCC. Cirrhotic patients do not seem to have the capacity to increase hepatic function in the treated part of the liver.
Registry name: Clinicaltrials.gov.
NCT03379844. Date of registration: 21 November 2017. Trial URL: https://clinicaltrials.gov/study/NCT03379844?cond=hcc&term=hepar primary&rank=1#study-overview .
研究肝胆闪烁显像（HBS）改善接受钬 - 166（Ho）微球放射性栓塞治疗的肝细胞癌（HCC）患者选择和治疗方案规划的可行性。
作为一项前瞻性2期研究的一部分，纳入31例HCC患者并接受Ho放射性栓塞治疗。27例患者符合分析条件，67%在影像学上表现为肝硬化肝脏形态，70%有多发病灶，51%有双侧病变。所有患者均无肝失代偿的临床体征（Child Pugh≤B7，中位MELD 9或ALBI - 2.55）。整体和区域肝功能基于使用200 MBq 锝 - 美布芬宁对HBS进行手动勾画，在筛查期间以及Ho放射性栓塞后约三个月采集，称为肝脏清除率（LCR）。与基线时的LCR一致，随访期间LCR与实验室检查结果之间存在显著相关性，包括胆红素、白蛋白、谷丙转氨酶、MELD评分和ALBI评分（p < 0.05）。HBS显示治疗肝脏的中位LCR显著降低（-16%；p = 0.0017），体积显著减小（-17%；p = 0.0027），未治疗肝脏无显著增加。非肝硬化患者总体LCR的中位相对变化为0%（范围 - 23 - 33%），肝硬化患者为 - 10%（范围 - 40 - 19%；p = 0.40）。
HBS显示HCC患者接受Ho微球放射性栓塞治疗的肝脏部分肝功能和体积显著降低。肝硬化患者似乎无法增加治疗肝脏部分的肝功能。
注册机构名称：Clinicaltrials.gov。
NCT03379844。注册日期：2017年11月21日。试验网址：https://clinicaltrials.gov/study/NCT03379844?cond=hcc&term=hepar primary&rank=1#study - overview 。
