Clinical evaluation of the partition model for estimating radiation doses from yttrium-90 microspheres in the treatment of hepatic cancer

Ho, S.; Lau, W. Y.; Leung, Thomas W.T.; Chan, M.; Johnson, P. J.; Li, A. K. C.

doi:10.1007/s002590050055

Cited by 58 publications

(71 citation statements)

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“…The method of calculating the required activity for injection and the actual dose delivered to the liver and lungs has been published previously. [12][13][14] In this study, the target tissue dose was 120 Gy. Depending on disease presentation, patients received treatment on a lobar basis at 4-to 6-week intervals.…”

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confidence: 99%

“…These treatments are being studied with and without standard therapies, including fluoropyrimidines, irinotecan, oxaliplatin, tyrosine kinase inhibitors, and vascular endothelial growth factor-and epidermal growth factor-targeting agents. 1,2,[9][10][11][12][13][14][15][16][17] The objective of the current study was to present safety and efficacy outcomes in patients with liverdominant colorectal metastases who were treated with hepatic-directed Y90.…”

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confidence: 99%

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Radioembolization of colorectal hepatic metastases using yttrium‐90 microspheres

Mulcahy

Lewandowski

Ibrahim

et al. 2009

Cancer

157

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BACKGROUND:The objective of the current study was to determine the safety and efficacy of Yttrium‐90 (Y90) microsphere treatment in patients with liver‐dominant colorectal metastases.METHODS:Seventy‐two patients with unresectable hepatic colorectal metastases were treated at a targeted absorbed dose of 120 Gray (Gy). Safety and toxicity were assessed using version 3 of the National Cancer Institute Common Terminology Criteria. Response was assessed by anatomic imaging and positron emission tomography (PET). Survival from the diagnosis of hepatic metastases and first treatment were estimated using the Kaplan‐Meier method. Substratification analyses were performed.RESULTS:The median dose delivered was 118 Gy. Treatment‐related toxicities included fatigue (61%), nausea (21%), and abdominal pain (25%). Grade 3 and 4 bilirubin toxicities were observed in 9 of 72 patients (12.6%). The tumor response rate was 40.3%. The median time to hepatic progression was 15.4 months, and the median response duration was 15 months. The PET response rate was 77%. Overall survival from the first Y90 treatment was 14.5 months. Tumor replacement (≤25% vs >25%) was associated with significantly greater median survival (18.7 months vs 5.2 months). The presence of extrahepatic disease was associated negatively with overall survival (7.9 months vs 21 months). Overall survival from the date of initial hepatic metastases was 34.6 months. A subset analysis of patients who had an Eastern Cooperative Oncology Group performance status of 0 demonstrated a median survival of 42.8 months and 23.5 months from the time of hepatic metastases and Y90 treatment, respectively.CONCLUSIONS:Y90 liver therapy appears to provide sustained disease stabilization with acceptable toxicity. Asymptomatic patients with preserved liver function at the time of Y90 appeared to benefit most from treatment. Cancer 2009. © 2009 American Cancer Society.

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Radioembolization of colorectal hepatic metastases using yttrium‐90 microspheres

Mulcahy

Lewandowski

Ibrahim

et al. 2009

Cancer

157

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“…The relationship between the 99m Tc-MAA SPECT-based tumor absorbed dose and tumor response is reported in several studies investigating the possibilities of treatment optimization by individualized 99m Tc-MAA SPECT-based dose planning. All published studies found a dose-efficacy correlation: with resin spheres, both in HCC [31] and in CRC metastases [32,33], and with glass spheres in HCC [34,35]. Statistically significant differences in the most important oncological end points, i.e., overall survival, progression-free survival and time to progression, were correlated with lesion absorbed doses higher or lower than about 200 Gy with glass spheres in HCC [36,37].…”

Section: Treatment Planning With 99m Tc-maa Spectmentioning

confidence: 98%

Multiagent imaging of liver tumors with reference to intra-arterial radioembolization

Maccauro¹,

Lorenzoni²,

Boni

et al. 2013

Clin Transl Imaging

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Intra-arterial radioembolization using microspheres labeled with the high-energy beta-emitter yttrium-90 ( 90 Y) is an innovative therapeutic strategy for primary and secondary hepatic malignancies. An accurate imaging workup plays a pivotal role in correctly selecting patients for treatment, to avoid severe complications and in assessment of the post-administration microsphere distribution. Nuclear medicine imaging modalities are an integral part of a complex multidisciplinary approach. In particular, hepatic perfusion imaging with 99m Tc-macroaggregated albumin particles ( 99m Tc-MAA), which identifies extrahepatic accumulation of radiopharmaceutical and lung shunt, is necessary to correctly select patients who may benefit from the treatment. Furthermore, 99m Tc MAA SPECT-based dose planning may optimize RE efficacy, overcoming the limitations of empirical methods to determine the activity to be administered. Quantitative assessment of the post-administration intrahepatic microsphere distribution with SPECT or PET is important for evaluation of toxicity and efficacy and can be used for the prediction of patient response and for patient-specific therapeutic dose optimization. Finally, [ 18 F]FDG PET/CT imaging is important in the assessment of early response after RE and in predicting patient outcome. This review provides a comprehensive overview of multimodality imaging in the complex management of patients undergoing RE for liver tumors.

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“…The intrahepatic tracer distribution and tumor-to-normal uptake ratio (TNR) are important for dose calculation especially when using a partition model. Many reports have suggested the correlation of 99m Tc MAA dosimetry and intraoperative estimation of radiation doses [6][7][8][9][10][11]. After the injection of the microsphere, postembolization evaluation for the distribution of 90 Y microspheres is essential to predict possible complications and treatment response [12].…”

Section: Introductionmentioning

confidence: 99%

Semi-Quantitative Analysis of Post-Transarterial Radioembolization 90Y Microsphere Positron Emission Tomography Combined with Computed Tomography (PET/CT) Images in Advanced Liver Malignancy: Comparison With 99mTc Macroaggregated Albumin (MAA) Single Photon Emission Computed Tomography (SPECT)

Rhee

Kim

Cho

et al. 2015

Nucl Med Mol Imaging

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Clinical evaluation of the partition model for estimating radiation doses from yttrium-90 microspheres in the treatment of hepatic cancer

Cited by 58 publications

References 0 publications

Radioembolization of colorectal hepatic metastases using yttrium‐90 microspheres

Radioembolization of colorectal hepatic metastases using yttrium‐90 microspheres

Multiagent imaging of liver tumors with reference to intra-arterial radioembolization

Semi-Quantitative Analysis of Post-Transarterial Radioembolization 90Y Microsphere Positron Emission Tomography Combined with Computed Tomography (PET/CT) Images in Advanced Liver Malignancy: Comparison With 99mTc Macroaggregated Albumin (MAA) Single Photon Emission Computed Tomography (SPECT)

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