International recommendations for personalised selective internal radiation therapy of primary and metastatic liver diseases with yttrium-90 resin microspheres.
Details
Serval ID
serval:BIB_6C03E818DE0B
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
International recommendations for personalised selective internal radiation therapy of primary and metastatic liver diseases with yttrium-90 resin microspheres.
Journal
European journal of nuclear medicine and molecular imaging
ISSN
1619-7089 (Electronic)
ISSN-L
1619-7070
Publication state
Published
Issued date
05/2021
Peer-reviewed
Oui
Volume
48
Number
5
Pages
1570-1584
Language
english
Notes
Publication types: Journal Article ; Research Support, Non-U.S. Gov't
Publication Status: ppublish
Publication Status: ppublish
Abstract
A multidisciplinary expert panel convened to formulate state-of-the-art recommendations for optimisation of selective internal radiation therapy (SIRT) with yttrium-90 ( <sup>90</sup> Y)-resin microspheres.
A steering committee of 23 international experts representing all participating specialties formulated recommendations for SIRT with <sup>90</sup> Y-resin microspheres activity prescription and post-treatment dosimetry, based on literature searches and the responses to a 61-question survey that was completed by 43 leading experts (including the steering committee members). The survey was validated by the steering committee and completed anonymously. In a face-to-face meeting, the results of the survey were presented and discussed. Recommendations were derived and level of agreement defined (strong agreement ≥ 80%, moderate agreement 50%-79%, no agreement ≤ 49%).
Forty-seven recommendations were established, including guidance such as a multidisciplinary team should define treatment strategy and therapeutic intent (strong agreement); 3D imaging with CT and an angiography with cone-beam-CT, if available, and <sup>99m</sup> Tc-MAA SPECT/CT are recommended for extrahepatic/intrahepatic deposition assessment, treatment field definition and calculation of the <sup>90</sup> Y-resin microspheres activity needed (moderate/strong agreement). A personalised approach, using dosimetry (partition model and/or voxel-based) is recommended for activity prescription, when either whole liver or selective, non-ablative or ablative SIRT is planned (strong agreement). A mean absorbed dose to non-tumoural liver of 40 Gy or less is considered safe (strong agreement). A minimum mean target-absorbed dose to tumour of 100-120 Gy is recommended for hepatocellular carcinoma, liver metastatic colorectal cancer and cholangiocarcinoma (moderate/strong agreement). Post-SIRT imaging for treatment verification with <sup>90</sup> Y-PET/CT is recommended (strong agreement). Post-SIRT dosimetry is also recommended (strong agreement).
Practitioners are encouraged to work towards adoption of these recommendations.
A steering committee of 23 international experts representing all participating specialties formulated recommendations for SIRT with <sup>90</sup> Y-resin microspheres activity prescription and post-treatment dosimetry, based on literature searches and the responses to a 61-question survey that was completed by 43 leading experts (including the steering committee members). The survey was validated by the steering committee and completed anonymously. In a face-to-face meeting, the results of the survey were presented and discussed. Recommendations were derived and level of agreement defined (strong agreement ≥ 80%, moderate agreement 50%-79%, no agreement ≤ 49%).
Forty-seven recommendations were established, including guidance such as a multidisciplinary team should define treatment strategy and therapeutic intent (strong agreement); 3D imaging with CT and an angiography with cone-beam-CT, if available, and <sup>99m</sup> Tc-MAA SPECT/CT are recommended for extrahepatic/intrahepatic deposition assessment, treatment field definition and calculation of the <sup>90</sup> Y-resin microspheres activity needed (moderate/strong agreement). A personalised approach, using dosimetry (partition model and/or voxel-based) is recommended for activity prescription, when either whole liver or selective, non-ablative or ablative SIRT is planned (strong agreement). A mean absorbed dose to non-tumoural liver of 40 Gy or less is considered safe (strong agreement). A minimum mean target-absorbed dose to tumour of 100-120 Gy is recommended for hepatocellular carcinoma, liver metastatic colorectal cancer and cholangiocarcinoma (moderate/strong agreement). Post-SIRT imaging for treatment verification with <sup>90</sup> Y-PET/CT is recommended (strong agreement). Post-SIRT dosimetry is also recommended (strong agreement).
Practitioners are encouraged to work towards adoption of these recommendations.
Keywords
Embolization, Therapeutic, Humans, Liver Neoplasms/radiotherapy, Microspheres, Positron Emission Tomography Computed Tomography, Technetium Tc 99m Aggregated Albumin, Yttrium Radioisotopes/therapeutic use, Dosimetry, Liver tumours, Recommendations, SIRT
Pubmed
Web of science
Open Access
Yes
Create date
25/01/2021 8:58
Last modification date
08/08/2024 6:35
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