Comparison of Dosimetry Results Before 90Y Microembolization Treatment with 99mTc MAA and After 90Y PET/CT Treatment

Öznur Taşlıyurt; Nami Yeyin; Mustafa Demir

doi:10.7197/cmj.1432517

TR EN

90Y Mikroembolizasyon Tedavisinde 99mTc MAA ile Tedavi Öncesi ve 90Y PET/BT Tedavi sonrası Dozimetri Sonuçlarının Karşılaştırılması

Öz

Karaciğer tümörleri tedavisinde Yitriyum 90 (90Y) mikroküreler ile yapılan radyoembolizasyon etkili bir tedavi seçeneğidir. Hastanın tedaviye uygunluğu rutinde 99mTc Makro Albümin Agregat (MAA) SPECT/BT görüntüleri üzerinden yapılan dozimetri ile belirlenir. Bu çalışmada, karaciğer tümör tedavisi için başvuran hastalarda 99mTc MAA tedavi öncesi (pre) dozimetri sonuçları ile 90Y mikroküre tedavi sonrası (post) dozimetri yapılarak sonuçlarının karşılaştırılması amaçlandı. Çalışmamıza karaciğer tümör tedavisi için başvuran ve rastgele seçilmiş 11 hasta dahil edildi. 99mTc-MAA dozimetrisinde,99mTc-MAA dozimetri ile hesaplanan tedavi aktivitesi 1.3-6.2 GBq (ortalama 3.2±1.4), tümör dozu 125.1-527.5 Gy (ortalama 264.7±139.4) ve karaciğer dozu 19.4-38.8 Gy (ortalama 31.9±5.8) bulundu. 90Y mikroküre tedavisinden sonra çekilen PET/BT görüntülerinden yapılan dozimetride tümör dozu 156.2-480.4 Gy (ortalama 266.5±102.9), karaciğer dozu 20.6-37.4 Gy (ortalama 29.1±5.2) bulundu. Dozlar, tümör ve normal karaciğer dokusu için iyi bir uyum gösterdi (p=0.85716 ve p=0.53526, sırasıyla). Sonuçta 90Y mikroküreler ile PET/BT’ye dayanan post dozimetrinin karaciğer parankim doku dozunu ve tümör dozunu belirlemede etkili bir yöntem olduğu belirlendi.

Anahtar Kelimeler

Comparison of Dosimetry Results Before 90Y Microembolization Treatment with 99mTc MAA and After 90Y PET/CT Treatment

Abstract

Radioembolization with Yttrium-90 (90Y) microspheres stands as an effective treatment option for liver tumors. The suitability of a patient for this treatment is routinely determined through dosimetry based on Technetium-99m Macro Aggregated Albumin (99mTc MAA) SPECT/CT images. This study aims to compare pre-treatment (pre) dosimetry results with 99mTc MAA and post-treatment (post) dosimetry results after 90Y microsphere therapy in patients seeking liver tumor treatment. Eleven patients undergoing liver tumor treatment were randomly included in the study. In 99mTc-MAA dosimetry, the calculated treatment activity was 1.3-6.2 GBq (mean 3.2±1.4), tumor dose was 125.1-527.5 Gy (mean 264.7±139.4), and liver dose was 19.4-38.8 Gy (mean 31.9±5.8). Post-dosimetry using PET/CT images after 90Y microsphere therapy revealed a tumor dose of 156.2-480.4 Gy (mean 266.5±102.9) and a liver dose of 20.6-37.4 Gy (mean 29.1±5.2). The doses exhibited good conformity for both tumor and normal liver tissue (p=0.85716 and p=0.53526, respectively). In conclusion, PET/CT-based post-dosimetry with 90Y microspheres proved to be an effective method in determining liver parenchymal tissue and tumor doses.

Keywords

Ethical Statement

The study was approved by the Local Ethics Committee of Cerrahpasa Faculty of Medicine/Istanbul University-Cerrahpasa in accordance with the Helsinki Declaration (Approval No: 83045809-604.01.02-). Informed consent was obtained from all participating patients.

References

Vente MA, Hobbelink MG, van Het Schip AD, Zonnenberg BA, Nijsen JF. Radionuclide liver cancer therapies: from concept to current clinical status. Anticancer Agents Med Chem. 2007;7(4):441-59. DOI: 10.2174/187152007781058569
Bozkurt M. F. Personalized Treatment and Protection from Side Effects. Nuclear Medicine Seminars 2019;5(2),:122-31.
Villalobos A, Soliman MM, Majdalany BS, et al. Yttrium-90 radioembolization dosimetry: what trainees need to know. In Seminars in Interventional Radiology 2020, 37(05): 543-54. DOI: 10.1055/s-0040-1720954
Tong A K, Kao Y H, Too CW, Chin K F, Ng DC, Chow P K. Yttrium-90 hepatic radioembolization: clinical review and current techniques in interventional radiology and personalized dosimetry. The British Journal of Radiology 2016;89(1062), 20150943.
Tafti BA, Padia SA. Dosimetry of Y-90 Microspheres Utilizing Tc-99m SPECT and Y-90 PET. Semin Nucl Med. 2019;49(3):211-17.
Richetta E, Pasquino M, Poli M, et al. PET-CT post therapy dosimetry in radioembolization with resin 90Y microspheres: comparison with pre-treatment SPECT-CT 99mTc-MAA results. Physica Medica 2019;64:16-23.DOI: 10.1016/j.ejmp.2019.05.025
Türkmen C, Demirci E, Selçuk NA, et al. Karaciğer Tümörlerinde Y-90 Radyomikroküre Tedavisi Uygulama Kılavuzu. Nucl Med Semin. 2020;6:416-22. DOI:10.4274/nts.galenos.2020.0034
Selcuk NA, Toklu T, Karaaslan SI. Radionuclide Treatment and Dosimetric Approaches. In Nuclear Medicine Seminars 2015;1(3):158-71.

Details

Primary Language

English

Subjects

Health Physics

Journal Section

Research Article

Authors

Öznur Taşlıyurt ^*
0009-0004-5872-1043
Türkiye

Nami Yeyin
0000-0003-0262-4020
Türkiye

Mustafa Demir
0000-0002-9813-1628
Türkiye

Publication Date

June 29, 2024

Submission Date

February 6, 2024

Acceptance Date

April 2, 2024

Published in Issue

Year 2024 Volume: 46 Number: 2

DOI

https://doi.org/10.7197/cmj.1432517

IZ

https://izlik.org/JA79BU32EC

Cite

RIS / Bibtex

AMA

1.Taşlıyurt Ö, Yeyin N, Demir M. Comparison of Dosimetry Results Before 90Y Microembolization Treatment with 99mTc MAA and After 90Y PET/CT Treatment. CMJ. 2024;46(2):104-109. doi:10.7197/cmj.1432517