Clinical Outcomes After Personalized Dosimetry for<sup>90</sup>Y Radioembolization of Advanced Hepatocellular Carcinoma: Defining the Role of a Device in a Pharma-Centric Landscape

Soulen, Michael C.; Rilling, William S.

doi:10.2967/jnumed.123.267035

J Nucl Med

2024

DOI: 10.2967/jnumed.123.267035

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Clinical Outcomes After Personalized Dosimetry for⁹⁰Y Radioembolization of Advanced Hepatocellular Carcinoma: Defining the Role of a Device in a Pharma-Centric Landscape

Michael C. Soulen,

William S. Rilling

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2024

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Cited by 2 publications

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Angiographic Aspects of Transarterial Radioembolization: A Comparison of Technical Options to Avoid Extrahepatic Microsphere Depositions

Etzel,

Drescher,

Bürckenmeyer

et al. 2024

Biomedicines

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The influence of the interventional treatment approach for transarterial radioembolization (TARE) on the incidence of extrahepatic microsphere depositions and to angiographic complications was evaluated. In total, 398 TARE cycles were analyzed. Interventional treatment approaches were classified as single treatment position (TP) with interventional occlusion (IO), multiple TPs without IO, and multiple TPs with IO. Correlations with extrahepatic microsphere depositions, angiographic complications, and periprocedural clinical events were performed. Alternative treatment strategies were evaluated. Applications from multiple TPs could have ensured the safe application of microspheres in 48.2% of cases that were originally performed from a single TP after IO. Extrahepatic microsphere accumulations were detected after 5.2%, 5.3%, and 1.5% of TARE procedures from a single TP without IO, a single TP with IO, and multiple TPs without IO, respectively. Applications from multiple TPs did not increase angiographic complications. During the 30-day follow-up, nausea/vomiting and upper abdominal discomfort were observed more frequently in the group with IO than in the group without IO (7.9%/4.6% and 9.2%/5.9%, respectively). In many TARE procedures, the same target liver can be treated from multiple TPs instead of a single TP, reducing the need for the interventional occlusion of aberrant arteries and potential extrahepatic microsphere depositions.

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Angiographic Aspects of Transarterial Radioembolization: A Comparison of Technical Options to Avoid Extrahepatic Microsphere Depositions

Etzel,

Drescher,

Bürckenmeyer

et al. 2024

Biomedicines

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Clinical Results of Holmium-166 Radioembolization with Personalized Dosimetry for the Treatment of Hepatocellular Carcinoma

Kühnel,

Köhler,

Brachwitz

et al. 2024

JPM

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Transarterial radioembolization (TARE) with 166Ho-loaded microspheres is an established locoregional treatment for hepatocellular carcinoma (HCC), introduced in 2010. This study evaluates the clinical outcome of patients with HCC who underwent 166Ho-TARE with personalized dosimetry. Twenty-seven patients with 36 TARE procedures were analyzed. Treatment planning, execution, and evaluation was possible without complications in all cases. At the 3-month follow-up, disease control in the treated liver was achieved in 81.8% of patients (complete remission, partial remission, and stable disease in 36.4%, 31.8%, and 13.6%, respectively). The median overall survival (OS) was 17.2 months, and progression-free survival (PFS) in the treated liver was 11 months. Statistically significant positive correlations were observed between the achieved radiation dose for the tumor and both PFS (r = 0.62, p < 0.05) and OS (r = 0.48, p < 0.05), suggesting a direct dose–response relationship. The calculated achieved dose was 8.25 Gy lower than the planned dose, with relevant variance between planned and achieved doses in individual cases. These results confirm the efficacy of the 166Ho-TARE holmium platform and underscore the potential of voxel-based, personalized dosimetry to improve clinical outcomes.

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Clinical Outcomes After Personalized Dosimetry for⁹⁰Y Radioembolization of Advanced Hepatocellular Carcinoma: Defining the Role of a Device in a Pharma-Centric Landscape

Cited by 2 publications

References 11 publications

Angiographic Aspects of Transarterial Radioembolization: A Comparison of Technical Options to Avoid Extrahepatic Microsphere Depositions

Angiographic Aspects of Transarterial Radioembolization: A Comparison of Technical Options to Avoid Extrahepatic Microsphere Depositions

Clinical Results of Holmium-166 Radioembolization with Personalized Dosimetry for the Treatment of Hepatocellular Carcinoma

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Clinical Outcomes After Personalized Dosimetry for90Y Radioembolization of Advanced Hepatocellular Carcinoma: Defining the Role of a Device in a Pharma-Centric Landscape

Cited by 2 publications

References 11 publications

Angiographic Aspects of Transarterial Radioembolization: A Comparison of Technical Options to Avoid Extrahepatic Microsphere Depositions

Angiographic Aspects of Transarterial Radioembolization: A Comparison of Technical Options to Avoid Extrahepatic Microsphere Depositions

Clinical Results of Holmium-166 Radioembolization with Personalized Dosimetry for the Treatment of Hepatocellular Carcinoma

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Product

Resources

About

Clinical Outcomes After Personalized Dosimetry for⁹⁰Y Radioembolization of Advanced Hepatocellular Carcinoma: Defining the Role of a Device in a Pharma-Centric Landscape