Utility of pre-procedural [99mTc]TcMAA SPECT/CT Multicompartment Dosimetry for Treatment Planning of 90Y Glass microspheres in patients with Hepatocellular Carcinoma: comparison of anatomic versus [99mTc]TcMAA-based Segmentation.

Détails

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Etat: Public
Version: Final published version
Licence: CC BY 4.0
ID Serval
serval:BIB_FBAD8255BF99
Type
Article: article d'un périodique ou d'un magazine.
Collection
Publications
Institution
Titre
Utility of pre-procedural [99mTc]TcMAA SPECT/CT Multicompartment Dosimetry for Treatment Planning of 90Y Glass microspheres in patients with Hepatocellular Carcinoma: comparison of anatomic versus [99mTc]TcMAA-based Segmentation.
Périodique
European journal of nuclear medicine and molecular imaging
Auteur⸱e⸱s
Lam M., Garin E., Haste P., Denys A., Geller B., Kappadath S.C., Turkmen C., Sze D.Y., Alsuhaibani H.S., Herrmann K., Maccauro M., Cantasdemir M., Dreher M., Fowers K.D., Gates V., Salem R.
ISSN
1619-7089 (Electronic)
ISSN-L
1619-7070
Statut éditorial
Publié
Date de publication
01/2025
Peer-reviewed
Oui
Volume
52
Numéro
2
Pages
744-755
Langue
anglais
Notes
Publication types: Journal Article ; Comparative Study
Publication Status: ppublish
Résumé
Pre-treatment [ <sup>99m</sup> Tc]TcMAA-based radioembolization treatment planning using multicompartment dosimetry involves the definition of the tumor and normal tissue compartments and calculation of the prescribed absorbed doses. The aim was to compare the real-world utility of anatomic and [ <sup>99m</sup> Tc]TcMAA-based segmentation of tumor and normal tissue compartments.
Included patients had HCC treated by glass [ <sup>90</sup> Y]yttrium microspheres, ≥ 1 tumor, ≥ 3 cm diameter and [ <sup>99m</sup> Tc]TcMAA SPECT/CT imaging before treatment. Segmentation was performed retrospectively using dedicated dosimetry software: (1) anatomic (diagnostic CT/MRI-based), and (2) [ <sup>99m</sup> Tc]TcMAA threshold-based (i.e., using an activity-isocontour threshold). CT/MRI was co-registered with [ <sup>99m</sup> Tc]TcMAA SPECT/CT. Logistic regression and Cox regression, respectively, were used to evaluate relationships between total perfused tumor absorbed dose (TAD) and objective response rate (ORR) and overall survival (OS). In a subset-analysis pre- and post-treatment dosimetry were compared using Bland-Altman analysis and Pearson's correlation coefficient.
A total of 209 patients were enrolled. Total perfused tumor and normal tissue volumes were larger when using anatomic versus [ <sup>99m</sup> Tc]TcMAA threshold segmentation, resulting in lower absorbed doses. mRECIST ORR was higher with increasing total perfused TAD (odds ratio per 100 Gy TAD increase was 1.22 (95% CI: 1.01-1.49; p = 0.044) for anatomic and 1.19 (95% CI: 1.04-1.37; p = 0.012) for [ <sup>99m</sup> Tc]TcMAA threshold segmentation. Higher total perfused TAD was associated with improved OS (hazard ratio per 100 Gy TAD increase was 0.826 (95% CI: 0.714-0.954; p = 0.009) and 0.847 (95% CI: 0.765-0.936; p = 0.001) for anatomic and [ <sup>99m</sup> Tc]TcMAA threshold segmentation, respectively). For pre- vs. post-treatment dosimetry comparison, the average bias for total perfused TAD was + 11.5 Gy (95% limits of agreement: -227.0 to 250.0) with a strong positive correlation (Pearson's correlation coefficient = 0.80).
Real-world data support [ <sup>99m</sup> Tc]TcMAA imaging to estimate absorbed doses prior to treatment of HCC with glass [ <sup>90</sup> Y]yttrium microspheres. Both anatomic and [ <sup>99m</sup> Tc]TcMAA threshold methods were suitable for treatment planning.
NCT03295006.
Mots-clé
Humans, Liver Neoplasms/diagnostic imaging, Liver Neoplasms/radiotherapy, Carcinoma, Hepatocellular/diagnostic imaging, Carcinoma, Hepatocellular/radiotherapy, Microspheres, Male, Female, Single Photon Emission Computed Tomography Computed Tomography, Aged, Middle Aged, Yttrium Radioisotopes/therapeutic use, Yttrium Radioisotopes/chemistry, Radiotherapy Planning, Computer-Assisted/methods, Radiometry, Retrospective Studies, Glass/chemistry, Technetium Tc 99m Aggregated Albumin, Aged, 80 and over, Radiopharmaceuticals/therapeutic use, Dosimetry, Hepatocellular carcinoma, Radioembolization, Segmentation, Yttrium-90
Pubmed
Web of science
Open Access
Oui
Création de la notice
30/09/2024 15:42
Dernière modification de la notice
25/02/2025 8:21
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