Purpose

To compare the accuracy and safety of 0.56 GBq resin yttrium-90 (⁹⁰Y) (scout⁹⁰Y) microspheres with those of technetium-99m macroaggregated albumin (MAA) in predicting the therapeutic ⁹⁰Y (Rx⁹⁰Y) dose for patients with hepatocellular carcinoma (HCC).

Materials and Methods

This prospective single-arm clinical trial (Clinicaltrials.gov: NCT04172714) recruited patients with HCC. Patients underwent same-day mapping with MAA and scout⁹⁰Y. Rx⁹⁰Y activity was administered 3 days after mapping. Using paired t test and Pearson correlation, the tumor-to-normal ratio (TNR), lung shunt fraction (LSF), predicted mean tumor dose (TD), and nontumoral liver dose (NTLD) by MAA and scout⁹⁰Y were compared with those by Rx⁹⁰Y. Bland-Altman plots compared the level of agreement between the TNR and LSF of scout⁹⁰Y and MAA with that of Rx⁹⁰Y. The safety of scout⁹⁰Y was evaluated by examining the discrepancy in extrahepatic activity between MAA and scout⁹⁰Y.

Results

Thirty patients were treated using 19 segmental and 14 nonsegmental (ie, 2 contiguous segments or nonsegmental) therapies. MAA had weak LSF, moderate TNR, and moderate TD linear correlation with Rx⁹⁰Y. Scout⁹⁰Y had a moderate LSF, strong TNR, strong TD, and very strong NTLD in correlation with those of Rx⁹⁰Y. Furthermore, the TNR and LSF of scout⁹⁰Y had a stronger agreement with those of Rx⁹⁰Y than with those of MAA. In the nonsegmental subgroup, MAA had no significant correlation with the TD and NTLD of Rx⁹⁰Y, whereas scout⁹⁰Y had a very strong correlation with both of these factors. In the segmental subgroup, both MAA and scout⁹⁰Y had a strong linear correlation with the TD and NTLD of Rx⁹⁰Y.

Conclusions

Compared with MAA, scout⁹⁰Y is a more accurate surrogate for Rx⁹⁰Y biodistribution for nonsegmental therapies.

中文翻译：

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用于放射栓塞治疗计划的 Scout Dose 树脂 Yttrium-90 微球的准确性和安全性：一项前瞻性单臂临床试验

目的

比较 0.56 GBq 树脂钇 90 ( ⁹⁰ Y) (scout ⁹⁰ Y) 微球与锝 99m 大聚集白蛋白 (MAA) 在预测肝细胞癌患者治疗性⁹⁰ Y (Rx ⁹⁰ Y) 剂量时的准确性和安全性癌（肝癌）。

材料和方法

这项前瞻性单臂临床试验 (Clinicaltrials.gov: NCT04172714) 招募了 HCC 患者。患者在同一天接受了 MAA 和⁹⁰ Y 的测绘。测绘后 3 天进行了Rx ^{90 Y 活动。}使用配对t检验和 Pearson 相关性，比较了MAA 和 scout ⁹⁰ Y 的肿瘤与正常比率 (TNR)、肺分流分数 (LSF)、预测平均肿瘤剂量 (TD) 和非肿瘤肝脏剂量 (NTLD)那些由 Rx ^{90 Y 绘制的。Bland-Altman 图比较了 scout 90} Y 和 MAA 与 Rx ⁹⁰ Y的 TNR 和 LSF 之间的一致性水平。scout ⁹⁰的安全性^{通过检查 MAA 和 scout 90} Y之间肝外活性的​​差异来评估 Y。

结果

30 名患者使用 19 种节段性和 14 种非节段性（即 2 个连续节段或非节段性）疗法进行治疗。^{MAA 与 Rx 90} Y具有弱 LSF、中等 TNR 和中等 TD 线性相关性。Scout ^{90 Y 与 Rx 90} Y 具有中等 LSF、强 TNR、强 TD 和非常强的 NTLD 相关性。此外，TNR 和侦察员⁹⁰ Y的 LSF与 Rx ⁹⁰ Y 的一致性比与 MAA 的一致性更强。^{在非分段亚组中，MAA 与 Rx 90} Y的 TD 和 NTLD 没有显着相关性，而 scout ⁹⁰ Y 与这两个因素都有很强的相关性。在分段子组中，MAA 和 scout ^{90Y 与 Rx 90} Y的 TD 和 NTLD 具有很强的线性相关性。

结论

与 MAA 相比，Scout ⁹⁰ Y 更准确地替代了非分段疗法的 Rx ⁹⁰ Y 生物分布。