Selective internal radiation therapy of hepatic tumors: Morphologic and functional imaging for voxel-based computer-aided dosimetry

Skanjeti, Andrea; Magand, Nicolas; Defez, Didier; Tordo, Jérémie; Rode, Agnès; Manichon, Anne Frédérique; Hallouard, François; Clave-Darcissac, Caroline; Dhomps, Anthony; Townsend, Danyelle M.; Rubello, Domenico; Giammarile, Francesco

doi:10.1016/j.biopha.2020.110865

Cited by 8 publications

(6 citation statements)

References 20 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…(23). Despite the promising findings, further verification is necessary since the study was based on a small sample size and over half of the lesions were excluded due to their small size (less than 2 cm in diameter) (27).…”

Section: Voxel-level Dose Kernel Convolutionmentioning

confidence: 99%

Quantification of Absorbed Dose in 90y Selective Internal Radiation Therapy for Hepatocellular Carcinoma Treatment: A Review

Baharuddin,

Baharul Amin,

Anan

et al. 2023

JUMMEC

View full text Add to dashboard Cite

Selective internal radiation therapy (SIRT) has emerged as a viable strategy for the treatment of incurable hepatic cancers. Although SIRT is a well-known therapy, continuous improvement in personalised dosimetry is required to improve the treatment planning and delivery of therapy. The ability to precisely foresee, plan, and administer the ideal dose to the tumour and non-tumoral tissues, including a final validation of the dose distribution, is the primary principle of radiation. The main way for safely personalised therapy for a maximum response while respecting normal tissue tolerances is to know the true absorbed dose to tissue compartments. Recent clinical studies highlighted the significance of personalised dosimetry to make it safer and more effective. Quantification of the absorbed dose distribution is of utmost importance in SIRT 90Y to optimise the hepatocellular carcinoma (HCC) treatment. The aim of this article was to review various dosimetric approaches in quantifying the absorbed dose of tumours and healthy liver tissue in 90Y SIRT. This article also compares the capabilities of organ-level dosimetry, voxel-level dosimetry and Monte Carlo simulation in assessing the absorbed dose in organs especially liver. The quantification of absorbed dose influences 90Y SIRT tumour dosimetry, while healthy liver absorbed dose values were comparable for all investigated imaging data. Personalised dosimetry for the tumour and healthy liver parenchyma after 90Y SIRT is recommended for patient-tailored therapy with enhanced therapeutic outcomes and for the safe administration of additional treatment cycles.

show abstract

Section: Voxel-level Dose Kernel Convolutionmentioning

confidence: 99%

Quantification of Absorbed Dose in 90y Selective Internal Radiation Therapy for Hepatocellular Carcinoma Treatment: A Review

Baharuddin,

Baharul Amin,

Anan

et al. 2023

JUMMEC

View full text Add to dashboard Cite

show abstract

“…The perfused tissue was the target hepatic volume that included normal liver parenchyma and tumoral lesion. The adaptive thresholding method was used to define the perfused tissue volume from functional imaging [15]. Perfused normal liver volume was defined as the perfused tissue volume minus the tumoral volume.…”

Section: Dosimetry Proceduresmentioning

confidence: 99%

The evaluation of DLCO changes in patients with relatively higher lung shunt fractions receiving TARE

et al. 2022

View full text Add to dashboard Cite

Objective Transarterial radioembolization (TARE) with Yttrium-90 ( 90 Y) labeled microspheres is an effective locoregional treatment option for patients with primary and metastatic liver cancer. However, TARE is also associated with radiationinduced lung injury due to hepatopulmonary shunting. If a large proportion of the injected radionuclide microspheres (more than 15%) is shunted, a rare but lethal complication may develop: radiation-induced pneumonitis (RP). Diffusion capacity of the lungs for carbon monoxide (DLCO) is a valuable test to assess lung function and a decrease in DLCO may indicate an impairment in gas exchange caused by the lung injury. Some previous researches have been reported the most consistent changes in pulmonary function tests after external beam radiotherapy are recorded with DLCO. This study aimed to examine the changes in DLCO after TARE with glass microspheres in newly treated and retreated patients with relatively higher lung shunt fractions. Methods We prospectively analyzed forty consecutive patients with liver malignancies who underwent lobar or superselective TARE with 90 Y glass microspheres. DLCO tests were performed at baseline and on days 15, 30, and 60 after the treatment. All patients were followed up clinically and radiologically for the development of RP. Results A statistically significant decrease was found in the DLCO after the first treatment (81.4 ± 13.66 vs. 75.25 ± 13.22, p = 0.003). The frequency of the patients with impaired DLCO at baseline was significantly increased after the first treatment (37.5 vs 57.5% p < 0.05). In the retreated group (n = 8), neither the DLCO (71.5 ± 10.82 vs. 67.50 ± 11.24, p = 0.115) nor the frequency of patients with impaired DLCO (25 vs 25%, p = 1) did not significantly change. Also, the change in DLCO values did not significantly correlate with lung shunt fraction, administered radiation dose, and absorbed lung dose after the first and second treatments (p > 0.05 for all). None of the patients developed RP. Conclusion Our study showed that a significant reduction in DLCO after TARE may occur in patients with relatively higher lung shunt fractions. Further studies with larger sample sizes are needed to better investigate the changes in DLCO in patients with high lung shunt fractions.

show abstract

“…Furthermore, voxel-based dosimetry offers an added level of personalization, as each voxel is considered as a separate source, allowing for visualization of 3D absorbed dose distributions and an evaluation of the degree of heterogeneity in both organs and targets through the use of dose volume histograms (DVHs) (48,49). Advancements in treatment planning software now offer semi-automatic 3D voxel dosimetry, providing tumour absorbed dose distributions and DVH per area of interest (50).…”

Section: Dosimetrymentioning

confidence: 99%

“…Sunitinib inhibits multiple tyrosine kinases and a multi-centre phase III randomized controlled trial revealed improved PFS among patients with advanced p-NET compared to placebo (49). Sunitinib is well tolerated and, except for diarrhoea, health-related quality of life (HRQOL) is not adversely impacted (50). Unlike everolimus, sunitinib is not approved for non-pancreatic GEP-NETs (48).…”

Section: Systemic Therapymentioning

confidence: 99%

“…In a post hoc analysis of one of the trials, pretreatment tumour-absorbed dose (TAD) was positively associated with OS (48). The degree to which 99mTc-MAA SPECT/CT and 90Y PET/CT TAD are associated is contested (49)(50)(51)(52). Differences between 99mTc-MAA and 90Y dosimetry exist, but only post-treatment dosimetry can validate predictive dosimetry (53).…”

Section: Hepatocellular Carcinomamentioning

confidence: 99%

See 1 more Smart Citation

Nuclear Imaging and Therapy

Veenstra

View full text Add to dashboard Cite

Book chapter 19 'Neuroendocrine Tumours Imaging and Image Guided Therapies' in Multimodality Imaging and Intervention in Oncology. Springer Nature. Not yet published. This chapter will focus on gastroenteropancreatic neuroendocrine tumours (GEP-NETs) in which NETs are named according to the location or the hormone they produce. Key Learning Points NETs are rare and often slow-growing tumours that arise from cells of the neuroendocrine system.  These tumours share the capability to produce amines and peptide hormones or to express a high density of somatostatin receptors on cell membranes.  Because of an overall indolent pattern of growth, most NETs are diagnosed in an advanced stage when patients present with mechanical symptoms due to tumour bulk.  The carcinoid syndrome can often be seen in small intestine NETs.  Several genetic disorders are linked to NETs such as MEN1-2 and von Recklinghausen's syndrome. G3-NEC68 Ga-SST PET/CT or SRSS and/or MRI (31) G3-NEC 68 Ga-SST PET/CT or SRSS and/or MRI (31)* * 18 FDG-PET for patients opting for radical surgery (31) G3-NEC Contrast-enhanced CT every 3-6 months for first 2-3 years, followed by every 6-12 months, or shorter. PET/CT for lymph node and bone lesions, MRI for liver and spine metastases (32) Gastroduodenal NETs G1-2 CT* (for metastases) (33) *Only for large (1-2 cm) and invasive tumours as detected by endoscopy (34) G1-3 68 Ga-SST PET/CT or SRSS and/or MRI (33,35)* * 18 FDG-PET and 11 C-5-HTP PET/CT for incidental findings (33)* G1-3 68 Ga-SST PET/CT or SRSS and/or MRI (33,35)* *Limited data concerning SST-imaging, potential use for detecting metastasis (33) G1-2 No (nuclear) imaging* G3 68 Ga-SST PET/CT or SRSS and/or MRI (33,35)* * 18 FDG-PET and 11 C-5-HTP PET/CT for incidental findings (33)* Pancreatic NETs G1-3 68 Ga-SST PET/CT or SRSS and/or MRI* (21,24)** *MRI has similar effectiveness in the detection of islet cell tumours (24) **Insulinoma: low sensitivity with 68 Ga-SST (21), consider GLP-1 analogue (8) G1-3 68 Ga-SST PET/CT or SRSS and/or MRI* (21,24)* *Use 18 FDG PET/CT in case of rapid tumour progression (36) G1-3 68 Ga-SST PET/CT or SRSS and/or MRI* (21,24) *Especially if LM are present use DW-MRI and DCE-MRI (32) G1-2 CT or MRI every 6-12 months if tumour <2cm for at least 5-10 years due to high risk of occurrence (37), otherwise surgery (21) G1-3 If progression is suspected, perform 68 Ga-SST PET/CT or SRSS and/or MRI (21,24) Small intestinal NETs G1-3 68 Ga-SST PET/CT or SRSS and/or MRI G1-2 68 Ga-SST PET/CT or SRSS and/or MRI* (29) G3 FDG-PET/CT (29) *MRI for bone scintigraphy G1-3 CT/MRI with water enteroclysis* G1-2 68 Ga-SST PET/CT or SRSS and/or MRI every 6-12 months* G3 68 Ga-SST PET/CT or SRSS and/or MRI*every 3 months* *Follow-up should be life-long (29) Colorectal NETs G1-2 No (nuclear) imaging G3 68 Ga-SST PET/CT or SRSS and/or pelvic MRI (10) G1-2 No (nuclear) imaging G3 18 F-FDG PET/CT

show abstract

Selective internal radiation therapy of hepatic tumors: Morphologic and functional imaging for voxel-based computer-aided dosimetry

Cited by 8 publications

References 20 publications

Quantification of Absorbed Dose in 90y Selective Internal Radiation Therapy for Hepatocellular Carcinoma Treatment: A Review

Quantification of Absorbed Dose in 90y Selective Internal Radiation Therapy for Hepatocellular Carcinoma Treatment: A Review

The evaluation of DLCO changes in patients with relatively higher lung shunt fractions receiving TARE

Nuclear Imaging and Therapy

Contact Info

Product

Resources

About