Hepatobiliary scintigraphy and liver function changes in patients with hepatocellular carcinoma treated with ¹⁶⁶Ho-radioembolization : HBS in HCC treated with holmium-166.

IF 3.1 3区医学 Q1 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING EJNMMI Research Pub Date : 2025-01-09 DOI:10.1186/s13550-025-01196-9

Margot T M Reinders, Maarten J L Smits, Karel van Erpecum, Joep de Bruijne, Rutger C G Bruijnen, Dave Sprengers, Rob de Man, Erik Vegt, Jan N M IJzermans, Marnix G E H Lam, Arthur J A T Braat

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Abstract

Background: To study the feasibility of hepatobiliary scintigraphy (HBS) to improve selection and planning of patients with hepatocellular carcinoma (HCC) treated with holmium-166 (¹⁶⁶Ho)-microspheres radioembolization.

Results: Thirty-one patients with HCC were included and treated with ¹⁶⁶Ho- radioembolization as part of a prospective phase 2 study. Twenty-seven patients were eligible for analysis, 67% had a cirrhotic liver morphology on imaging, 70% had multifocal disease and 51% had bilobar disease. None of the patients had clinical signs of liver decompensation (Child Pugh ≤ B7, median MELD 9 or ALBI - 2.55). Global and regional hepatic function was based on manual delineation of HBS using 200 MBq ^99mTc-mebrofenine, acquired during screening and approximately three months after ¹⁶⁶Ho-radioembolization, referred to as liver clearance rate (LCR). In line with LCR at baseline, a significant correlation was found between LCR and lab results, including bilirubin, albumin, ALT, MELD-score, and ALBI-score (p < 0.05) during follow-up. HBS showed a significant decrease in median LCR (-16%; p = 0.0017) and volume (-17%; p = 0.0027) in the treated liver, without a significant increase in the non-treated liver. Median relative change in overall LCR in non-cirrhotics was 0% (range - 23-33%), in cirrhotics - 10% (range - 40 - 19%; p = 0.40).

Conclusion: HBS showed that hepatic function and volume significantly decreased in parts of the liver treated with ¹⁶⁶Ho-microspheres radioembolization in patients with HCC. Cirrhotic patients do not seem to have the capacity to increase hepatic function in the treated part of the liver.

Trial registration: Registry name: Clinicaltrials.gov.

Trial number: NCT03379844. Date of registration: 21 November 2017. Trial URL: https://clinicaltrials.gov/study/NCT03379844?cond=hcc&term=hepar primary&rank=1#study-overview .

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166ho -放射栓塞治疗肝细胞癌患者肝胆造影和肝功能改变：钬-166治疗肝细胞癌患者肝胆造影和肝功能改变

背景：研究肝胆闪烁成像（HBS）在改善钬-166 （166Ho）微球放射栓塞治疗肝细胞癌（HCC）患者选择和计划中的可行性。结果：31例HCC患者接受了166Ho-放射栓塞治疗，这是一项前瞻性2期研究的一部分。27例患者符合分析条件，67%影像学表现为肝硬化，70%为多灶性疾病，51%为双叶性疾病。所有患者均无肝失代偿的临床症状（Child Pugh≤B7，中位MELD 9或ALBI - 2.55）。全球和区域肝功能基于人工描述HBS，使用200 MBq 99mtc -甲溴非宁，在筛查期间和166ho放射栓塞后约三个月获得，称为肝清除率（LCR）。与基线时的LCR一致，LCR与实验室结果，包括胆红素、白蛋白、ALT、meld评分和albi评分之间存在显著相关性(p)。结论：HBS显示HCC患者接受166ho微球放射栓塞治疗的部分肝脏功能和体积显著下降。肝硬化患者似乎没有能力在肝脏的治疗部分增加肝功能。试验注册：注册中心名称：clinicaltrials .gov.试验编号：NCT03379844。注册日期：2017年11月21日。试用网址：https://clinicaltrials.gov/study/NCT03379844?cond=hcc&term=hepar primary&rank=1#研究概述。

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来源期刊

EJNMMI Research RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING&nb-

CiteScore

5.90

自引率

3.10%

发文量

审稿时长

13 weeks

期刊介绍： EJNMMI Research publishes new basic, translational and clinical research in the field of nuclear medicine and molecular imaging. Regular features include original research articles, rapid communication of preliminary data on innovative research, interesting case reports, editorials, and letters to the editor. Educational articles on basic sciences, fundamental aspects and controversy related to pre-clinical and clinical research or ethical aspects of research are also welcome. Timely reviews provide updates on current applications, issues in imaging research and translational aspects of nuclear medicine and molecular imaging technologies. The main emphasis is placed on the development of targeted imaging with radiopharmaceuticals within the broader context of molecular probes to enhance understanding and characterisation of the complex biological processes underlying disease and to develop, test and guide new treatment modalities, including radionuclide therapy.