Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2024 Jul;38(7):525-533.
doi: 10.1007/s12149-024-01926-4. Epub 2024 Apr 22.

Use of dose-volume histograms for metabolic response prediction in hepatocellular carcinoma patients undergoing transarterial radioembolization with Y-90 resin microspheres

Nazim Coskun  1   2 , Mehmet Oguz Kartal  3 , Aysenur Sinem Kartal  3 , Velihan Cayhan  4 , Mustafa Ozdemir  4   5 , Murat Canyigit  4   6 , Elif Ozdemir  7   3
Affiliations

Use of dose-volume histograms for metabolic response prediction in hepatocellular carcinoma patients undergoing transarterial radioembolization with Y-90 resin microspheres

Nazim Coskun et al. Ann Nucl Med. 2024 Jul.

Abstract

Introduction: Voxel-based dosimetry offers improved outcomes in the treatment of hepatocellular carcinoma (HCC) with transarterial radioembolization (TARE) using glass microspheres. However, the adaptation of voxel-based dosimetry to resin-based microspheres has been poorly studied, and the prognostic relevance of heterogeneous dose distribution remains unclear. This study aims to explore the use of dose-volume histograms for resin microspheres and to determine thresholds for objective metabolic response in HCC patients treated with resin-based TARE.

Methods: We retrospectively reviewed HCC patients who underwent TARE with Y-90-loaded resin microspheres in our institution between January 2021 and December 2022. Voxel-based dosimetry was performed on post-treatment Y-90 PET/CT images to extract parameters including mean dose absorbed by the tumor (mTD), the percentage of the targeted tumor volume (pTV), and the minimum doses absorbed by consecutive percentages within the tumor volume (D10, D25, D50, D75, D90). Assessment of metabolic response was done according to PERCIST criteria with F-18 FDG PET/CT imaging at 8-12 weeks after the treatment.

Results: This study included 35 lesions targeted with 22 TARE sessions in 19 patients (15 males, 4 females, mean age 60 ± 13 years). Objective metabolic response was achieved in 43% of the lesions (n = 15). Responsive lesions had significantly higher mTD, pTV, and D25-D90 values (all p < 0.05). Optimal cut-off values for mTD, pTV, and D50 were 94.6 Gy (sensitivity 73%, specificity 70%, AUC 0.72), 94% (sensitivity 73%, specificity 55%, AUC 0.64), and 91 Gy (sensitivity 80%, specificity 80%, AUC 0.80), respectively.

Conclusion: Parameters derived from dose-volume histograms could offer valuable insights for predicting objective metabolic response in HCC patients treated with resin-based TARE. If verified with larger prospective cohorts, these parameters could enhance the precision of dose distribution and potentially optimize treatment outcomes.

Keywords: Dose–volume histogram; Hepatocellular carcinoma; Transarterial radioembolization.

PubMed Disclaimer

Similar articles

See all similar articles

Cited by

References

    1. Dancey JE, Shepherd FA, Paul K, Sniderman KW, Houle S, Gabrys J, et al. Treatment of nonresectable hepatocellular carcinoma with intrahepatic 90Y-microspheres. J Nucl Med. 2000;41(10):1673–81. - PubMed
    1. Garin E, Rolland Y, Laffont S, Edeline J. Clinical impact of 99m Tc-MAA SPECT/CT-based dosimetry in the radioembolization of liver malignancies with 90 Y-loaded microspheres. Eur J Nucl Med Mol Imaging. 2016;43:559–75. - DOI - PubMed
    1. Weber M, Lam M, Chiesa C, Konijnenberg M, Cremonesi M, Flamen P, et al. EANM procedure guideline for the treatment of liver cancer and liver metastases with intra-arterial radioactive compounds. Eur J Nucl Med Mol Imaging. 2022;49(5):1682–99. - DOI - PubMed - PMC
    1. Kao YH, Tan AEH, Burgmans MC, Irani FG, Khoo LS, Lo RHG, et al. Image-guided personalized predictive dosimetry by artery-specific SPECT/CT partition modeling for safe and effective 90Y radioembolization. J Nucl Med. 2012;53(4):559–66. - DOI - PubMed
    1. Ho S, Lau W, Leung T, Chan M, Ngar Y, Johnson P, Li A. Partition model for estimating radiation doses from yttrium-90 microspheres in treating hepatic tumours. Eur J Nucl Med Mol Imaging. 1996;23:947–52. - DOI

MeSH terms

LinkOut - more resources