TY - JOUR
T1 - Hepatobiliary scintigraphy may improve radioembolization treatment planning in HCC patients
AU - Braat, Manon N G J A
AU - de Jong, Hugo W
AU - Seinstra, Beatrijs A
AU - Scholten, Mike V
AU - van den Bosch, Maurice A A J
AU - Lam, Marnix G E H
N1 - Publisher Copyright:
© 2017, The Author(s).
PY - 2017
Y1 - 2017
N2 - BACKGROUND: Routine work-up for transarterial radioembolization, based on clinical and laboratory parameters, sometimes fails, resulting in severe hepatotoxicity in up to 5% of patients. Quantitative assessment of the pretreatment liver function and its segmental distribution, using hepatobiliary scintigraphy may improve patient selection and treatment planning. A case series will be presented to illustrate the potential of this technique. Hepatocellular carcinoma patients with cirrhosis (Child-Pugh A and B) underwent hepatobiliary scintigraphy pre- and 3 months post-radioembolization as part of a prospective study protocol, which was prematurely terminated because of limited accrual. Included patients were analysed together with their clinical, laboratory and treatment data.RESULTS: Pretreatment-corrected (99m)Tc-mebrofenin liver uptake rates were marginal (1.8-3.0%/min/m(2)), despite acceptable clinical and laboratory parameters. Posttreatment liver functions seriously declined (corrected (99m)Tc-mebrofenin liver uptake rates: 0.6-2.4%/min/m(2)), resulting in lethal radioembolization-induced liver disease in two out of three patients.CONCLUSIONS: Hepatobiliary scintigraphy may be of added value during work-up for radioembolization, to estimate liver function reserve and its segmental distribution, especially in patients with underlying cirrhosis, for whom analysis of clinical and laboratory parameters may not be sufficient.
AB - BACKGROUND: Routine work-up for transarterial radioembolization, based on clinical and laboratory parameters, sometimes fails, resulting in severe hepatotoxicity in up to 5% of patients. Quantitative assessment of the pretreatment liver function and its segmental distribution, using hepatobiliary scintigraphy may improve patient selection and treatment planning. A case series will be presented to illustrate the potential of this technique. Hepatocellular carcinoma patients with cirrhosis (Child-Pugh A and B) underwent hepatobiliary scintigraphy pre- and 3 months post-radioembolization as part of a prospective study protocol, which was prematurely terminated because of limited accrual. Included patients were analysed together with their clinical, laboratory and treatment data.RESULTS: Pretreatment-corrected (99m)Tc-mebrofenin liver uptake rates were marginal (1.8-3.0%/min/m(2)), despite acceptable clinical and laboratory parameters. Posttreatment liver functions seriously declined (corrected (99m)Tc-mebrofenin liver uptake rates: 0.6-2.4%/min/m(2)), resulting in lethal radioembolization-induced liver disease in two out of three patients.CONCLUSIONS: Hepatobiliary scintigraphy may be of added value during work-up for radioembolization, to estimate liver function reserve and its segmental distribution, especially in patients with underlying cirrhosis, for whom analysis of clinical and laboratory parameters may not be sufficient.
KW - Hepatobiliary scintigraphy
KW - Hepatotoxicity
KW - Radioembolization
KW - Yttrium-90
UR - http://www.scopus.com/inward/record.url?scp=85008602519&partnerID=8YFLogxK
U2 - 10.1186/s13550-016-0248-x
DO - 10.1186/s13550-016-0248-x
M3 - Article
C2 - 28058660
SN - 2197-7364
VL - 7
JO - EJNMMI physics
JF - EJNMMI physics
IS - 1
M1 - 2
ER -