TY - JOUR
T1 - Comparison of 3 Different Therapeutic Particles in Radioembolization of Locally Advanced Intrahepatic Cholangiocarcinoma
AU - Wagemans, Martijn E H M
AU - Kunnen, Britt
AU - Stella, Martina
AU - van Rooij, Rob
AU - Lam, Marnix G E H
AU - de Jong, Hugo W A M
AU - Braat, Arthur J A T
N1 - Publisher Copyright:
© 2024 by the Society of Nuclear Medicine and Molecular Imaging.
PY - 2024/2/1
Y1 - 2024/2/1
N2 - Our objective was to compare 3 different therapeutic particles used for radioembolization in locally advanced intrahepatic cholangiocarcinoma.
Methods:
90Y-glass,
90Y-resin, and
166Ho-labeled poly(l-lactic acid) microsphere prescribed activity was calculated as per manufacturer recommendations. Posttreatment quantitative
90Y PET/CT and quantitative
166Ho SPECT/CT were used to determine tumor-absorbed dose, whole-normal-liver-absorbed dose, treated-normal-liver-absorbed dose, tumor-to-nontumor ratio, lung-absorbed dose, and lung shunt fraction. Response was assessed using RECIST 1.1 and the [
18F]FDG PET-based change in total lesion glycolysis. Hepatotoxicity was assessed using the radioembolization-induced liver disease classification.
Results: Six
90Y-glass, 8
90Y-resin, and 7
166Ho microsphere patients were included for analysis. The mean administered activity was 2.6 GBq for
90Y-glass, 1.5 GBq for
90Y-resin, and 7.0 GBq for
166Ho microspheres. Tumor-absorbed dose and treated-normal-liver-absorbed dose were significantly higher for
90Y-glass than for
90Y-resin and
166Ho microspheres (mean tumor-absorbed dose, 197 Gy for
90Y-glass vs. 73 Gy for
90Y-resin and 50 Gy for
166Ho; mean treated-normal-liver-absorbed dose, 79 Gy for
90Y-glass vs. 37 Gy for
90Y-resin and 31 Gy for
166Ho). The whole-normal-liver-absorbed dose and tumor-to-nontumor ratio did not significantly differ between the particles. All patients had a lung-absorbed dose under 30 Gy and a lung shunt fraction under 20%. The 3 groups showed similar toxicity and response according to RECIST 1.1 and [
18F]FDG PET-based total lesion glycolysis changes.
Conclusion: The therapeutic particles used for radioembolization differed from each other and showed significant differences in absorbed dose, whereas toxicity and response were similar for all groups. This finding emphasizes the need for separate dose constraints and dose targets for each particle.
AB - Our objective was to compare 3 different therapeutic particles used for radioembolization in locally advanced intrahepatic cholangiocarcinoma.
Methods:
90Y-glass,
90Y-resin, and
166Ho-labeled poly(l-lactic acid) microsphere prescribed activity was calculated as per manufacturer recommendations. Posttreatment quantitative
90Y PET/CT and quantitative
166Ho SPECT/CT were used to determine tumor-absorbed dose, whole-normal-liver-absorbed dose, treated-normal-liver-absorbed dose, tumor-to-nontumor ratio, lung-absorbed dose, and lung shunt fraction. Response was assessed using RECIST 1.1 and the [
18F]FDG PET-based change in total lesion glycolysis. Hepatotoxicity was assessed using the radioembolization-induced liver disease classification.
Results: Six
90Y-glass, 8
90Y-resin, and 7
166Ho microsphere patients were included for analysis. The mean administered activity was 2.6 GBq for
90Y-glass, 1.5 GBq for
90Y-resin, and 7.0 GBq for
166Ho microspheres. Tumor-absorbed dose and treated-normal-liver-absorbed dose were significantly higher for
90Y-glass than for
90Y-resin and
166Ho microspheres (mean tumor-absorbed dose, 197 Gy for
90Y-glass vs. 73 Gy for
90Y-resin and 50 Gy for
166Ho; mean treated-normal-liver-absorbed dose, 79 Gy for
90Y-glass vs. 37 Gy for
90Y-resin and 31 Gy for
166Ho). The whole-normal-liver-absorbed dose and tumor-to-nontumor ratio did not significantly differ between the particles. All patients had a lung-absorbed dose under 30 Gy and a lung shunt fraction under 20%. The 3 groups showed similar toxicity and response according to RECIST 1.1 and [
18F]FDG PET-based total lesion glycolysis changes.
Conclusion: The therapeutic particles used for radioembolization differed from each other and showed significant differences in absorbed dose, whereas toxicity and response were similar for all groups. This finding emphasizes the need for separate dose constraints and dose targets for each particle.
KW - Ho
KW - Y
KW - intrahepatic cholangiocarcinoma
KW - microspheres
KW - radioembolization
UR - http://www.scopus.com/inward/record.url?scp=85184278255&partnerID=8YFLogxK
U2 - 10.2967/jnumed.123.265597
DO - 10.2967/jnumed.123.265597
M3 - Article
C2 - 38176716
SN - 0161-5505
VL - 65
SP - 272
EP - 278
JO - Journal of nuclear medicine : official publication, Society of Nuclear Medicine
JF - Journal of nuclear medicine : official publication, Society of Nuclear Medicine
IS - 2
ER -