{"title":"比较接受99m锝-MAA和90Y-微球放射栓塞治疗的肝癌患者肿瘤肝脏和非肿瘤肝脏的吸收剂量。","authors":"Nut Noipinit, Chanan Sukprakun, Punnarai Siricharoen, Kitiwat Khamwan","doi":"10.1007/s12149-023-01890-5","DOIUrl":null,"url":null,"abstract":"<div><h3>Purpose</h3><p>This study aimed to determine the absorbed doses in the tumoral-liver and non-tumoral liver of hepatocellular carcinoma (HCC) patients undergoing radioembolization with Yttrium-90 (<sup>90</sup>Y) resin microspheres, and compared with those derived from <sup>99m</sup>Tc-MAA using the partition model.</p><h3>Methods</h3><p>A total of 42 HCC patients (28 males and 14 females, mean age 65 ± 11.51 years) who received 45 treatment sessions with <sup>90</sup>Y-microspheres between 2016 and 2021 were included. Pre-treatment <sup>99m</sup>Tc-MAA and post-treatment <sup>90</sup>Y-bremsstrahlung SPECT/CT were acquired for each patient. Semi-automated segmentation of regions of interest (ROIs) was performed using MIM Encore software to determine the tumor-liver ratio (TLR) encompassing the liver volume, tumoral-liver, and lungs, and verified by both nuclear medicine physician and interventional radiologist. A partition dosimetry model was used to estimate the administered activity of <sup>90</sup>Y-microspheres and the absorbed doses to the tumoral-liver and non-tumoral liver. The student’s paired <i>t</i> test and Bland–Altman plot were used for the statistical analysis.</p><h3>Results</h3><p>The mean TLR values obtained from <sup>99m</sup>Tc-MAA SPECT/CT and <sup>90</sup>Y-bremsstrahlung SPECT/CT were 4.78 ± 3.51 and 2.73 ± 1.18, respectively. The mean planning administered activity of <sup>90</sup>Y-microspheres based on <sup>99m</sup>Tc-MAA SPECT/CT was 1.56 ± 0.80 GBq, while the implanted administered activity was 2.53 ± 1.23 GBq (<i>p</i> value < 0.001). The mean absorbed doses in the tumoral-liver estimated from <sup>99m</sup>Tc-MAA and <sup>90</sup>Y-bremsstrahlung SPECT/CT were 127.44 ± 4.36 Gy and 135.98 ± 6.30 Gy, respectively. The corresponding mean absorbed doses in the non-tumoral liver were 34.61 ± 13.93 Gy and 55.04 ± 16.36 Gy.</p><h3>Conclusion</h3><p>This study provides evidence that the administered activity of <sup>90</sup>Y-microspheres, as estimated from <sup>90</sup>Y-bremsstrahlung SPECT/CT, was significantly higher than that estimated from <sup>99m</sup>Tc-MAA SPECT/CT resulted in increased absorbed doses in both the tumoral-liver and non-tumoral liver. However, <sup>99m</sup>Tc-MAA SPECT/CT remains a valuable planning tool for predicting the distribution of <sup>90</sup>Y-microspheres in liver cancer treatment.</p></div>","PeriodicalId":8007,"journal":{"name":"Annals of Nuclear Medicine","volume":null,"pages":null},"PeriodicalIF":2.5000,"publicationDate":"2023-12-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Comparison of absorbed doses to the tumoral and non-tumoral liver in HCC patients undergoing 99mTc-MAA and 90Y-microspheres radioembolization\",\"authors\":\"Nut Noipinit, Chanan Sukprakun, Punnarai Siricharoen, Kitiwat Khamwan\",\"doi\":\"10.1007/s12149-023-01890-5\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div><h3>Purpose</h3><p>This study aimed to determine the absorbed doses in the tumoral-liver and non-tumoral liver of hepatocellular carcinoma (HCC) patients undergoing radioembolization with Yttrium-90 (<sup>90</sup>Y) resin microspheres, and compared with those derived from <sup>99m</sup>Tc-MAA using the partition model.</p><h3>Methods</h3><p>A total of 42 HCC patients (28 males and 14 females, mean age 65 ± 11.51 years) who received 45 treatment sessions with <sup>90</sup>Y-microspheres between 2016 and 2021 were included. Pre-treatment <sup>99m</sup>Tc-MAA and post-treatment <sup>90</sup>Y-bremsstrahlung SPECT/CT were acquired for each patient. Semi-automated segmentation of regions of interest (ROIs) was performed using MIM Encore software to determine the tumor-liver ratio (TLR) encompassing the liver volume, tumoral-liver, and lungs, and verified by both nuclear medicine physician and interventional radiologist. A partition dosimetry model was used to estimate the administered activity of <sup>90</sup>Y-microspheres and the absorbed doses to the tumoral-liver and non-tumoral liver. The student’s paired <i>t</i> test and Bland–Altman plot were used for the statistical analysis.</p><h3>Results</h3><p>The mean TLR values obtained from <sup>99m</sup>Tc-MAA SPECT/CT and <sup>90</sup>Y-bremsstrahlung SPECT/CT were 4.78 ± 3.51 and 2.73 ± 1.18, respectively. The mean planning administered activity of <sup>90</sup>Y-microspheres based on <sup>99m</sup>Tc-MAA SPECT/CT was 1.56 ± 0.80 GBq, while the implanted administered activity was 2.53 ± 1.23 GBq (<i>p</i> value < 0.001). The mean absorbed doses in the tumoral-liver estimated from <sup>99m</sup>Tc-MAA and <sup>90</sup>Y-bremsstrahlung SPECT/CT were 127.44 ± 4.36 Gy and 135.98 ± 6.30 Gy, respectively. The corresponding mean absorbed doses in the non-tumoral liver were 34.61 ± 13.93 Gy and 55.04 ± 16.36 Gy.</p><h3>Conclusion</h3><p>This study provides evidence that the administered activity of <sup>90</sup>Y-microspheres, as estimated from <sup>90</sup>Y-bremsstrahlung SPECT/CT, was significantly higher than that estimated from <sup>99m</sup>Tc-MAA SPECT/CT resulted in increased absorbed doses in both the tumoral-liver and non-tumoral liver. However, <sup>99m</sup>Tc-MAA SPECT/CT remains a valuable planning tool for predicting the distribution of <sup>90</sup>Y-microspheres in liver cancer treatment.</p></div>\",\"PeriodicalId\":8007,\"journal\":{\"name\":\"Annals of Nuclear Medicine\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":2.5000,\"publicationDate\":\"2023-12-24\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Annals of Nuclear Medicine\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://link.springer.com/article/10.1007/s12149-023-01890-5\",\"RegionNum\":4,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q2\",\"JCRName\":\"RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Annals of Nuclear Medicine","FirstCategoryId":"3","ListUrlMain":"https://link.springer.com/article/10.1007/s12149-023-01890-5","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING","Score":null,"Total":0}
Comparison of absorbed doses to the tumoral and non-tumoral liver in HCC patients undergoing 99mTc-MAA and 90Y-microspheres radioembolization
Purpose
This study aimed to determine the absorbed doses in the tumoral-liver and non-tumoral liver of hepatocellular carcinoma (HCC) patients undergoing radioembolization with Yttrium-90 (90Y) resin microspheres, and compared with those derived from 99mTc-MAA using the partition model.
Methods
A total of 42 HCC patients (28 males and 14 females, mean age 65 ± 11.51 years) who received 45 treatment sessions with 90Y-microspheres between 2016 and 2021 were included. Pre-treatment 99mTc-MAA and post-treatment 90Y-bremsstrahlung SPECT/CT were acquired for each patient. Semi-automated segmentation of regions of interest (ROIs) was performed using MIM Encore software to determine the tumor-liver ratio (TLR) encompassing the liver volume, tumoral-liver, and lungs, and verified by both nuclear medicine physician and interventional radiologist. A partition dosimetry model was used to estimate the administered activity of 90Y-microspheres and the absorbed doses to the tumoral-liver and non-tumoral liver. The student’s paired t test and Bland–Altman plot were used for the statistical analysis.
Results
The mean TLR values obtained from 99mTc-MAA SPECT/CT and 90Y-bremsstrahlung SPECT/CT were 4.78 ± 3.51 and 2.73 ± 1.18, respectively. The mean planning administered activity of 90Y-microspheres based on 99mTc-MAA SPECT/CT was 1.56 ± 0.80 GBq, while the implanted administered activity was 2.53 ± 1.23 GBq (p value < 0.001). The mean absorbed doses in the tumoral-liver estimated from 99mTc-MAA and 90Y-bremsstrahlung SPECT/CT were 127.44 ± 4.36 Gy and 135.98 ± 6.30 Gy, respectively. The corresponding mean absorbed doses in the non-tumoral liver were 34.61 ± 13.93 Gy and 55.04 ± 16.36 Gy.
Conclusion
This study provides evidence that the administered activity of 90Y-microspheres, as estimated from 90Y-bremsstrahlung SPECT/CT, was significantly higher than that estimated from 99mTc-MAA SPECT/CT resulted in increased absorbed doses in both the tumoral-liver and non-tumoral liver. However, 99mTc-MAA SPECT/CT remains a valuable planning tool for predicting the distribution of 90Y-microspheres in liver cancer treatment.
期刊介绍：
Annals of Nuclear Medicine is an official journal of the Japanese Society of Nuclear Medicine. It develops the appropriate application of radioactive substances and stable nuclides in the field of medicine.
The journal promotes the exchange of ideas and information and research in nuclear medicine and includes the medical application of radionuclides and related subjects. It presents original articles, short communications, reviews and letters to the editor.
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