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Tuesday, September 30, 2014

Researchers investigate new methods for dose quantification following Y-90 using PET/CT

Hepatocellular carcinoma is often managed using a lobar arterial injection of Yttrium-90 radioembolization therapy. This study describes the use of PET-CT to localize and quantify the dose after glass microsphere Y-90 therapy. This retrospective single institution study looked at 64 post-radioembolization “dose maps” created from reconstructed PET-CT images. Contouring of the liver parenchyma and tumors (using pre-procedure imaging if needed) was performed and aligned with these dose maps. A total of 113 tumors were evaluated with an average size of 4.8 cm ±4. The average tumor dose was 173 Gy ±109 and the average non-tumor liver parenchyma dose was 93.4 Gy ±32.6. The calculated average tumor-to-parenchyma dose ratio was 2.2, which suggested a preferential Y-90 uptake within the tumors.

The authors were able to characterize the dose deposition of Y-90 in a large cohort of HCC patients being treated using the recommended dose administration algorithms. The study quantifies the well-known, extremely heterogeneous microsphere deposition and highlights the error of applying broad dosing guidelines to all patients. This imaging technique is a valuable tool for any study looking to optimize dosing and clinical response and should be considered for future research studies evaluating the wide discrepancies between dosing and deposition.

Click here to see the full abstract 

Citation:  Lea WB, Tapp KN, Tann M, et al. 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)

Post author: Nicholas Hendricks, MD

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