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Comparative dosimetry between 99mTc-MAA SPECT/CT and 90Y PET/CT in primary and metastatic liver tumors

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Abstract

Introduction

The aim of this study is to determine whether 99mTc-MAA SPECT/CT-based dosimetry could predict the actual absorbed dose in hepatocellular carcinoma (HCC) or liver metastases, treated by glass or resin microspheres.

Material and methods

Fifty-seven patients who underwent selective internal radiation therapy (SIRT) were retrospectively included in the study, for a total of 59 treatments. Nineteen HCC were treated by resin microspheres (HCC-SIR), 20 HCC with glass microspheres (HCC-Thera), and 20 liver metastases with resin microspheres (Metastases-SIR). The mean absorbed doses in tumoral liver (Dm) and non-tumoral liver (DmNTL) were determined on the 99mTc-MAA SPECT/CT and the 90Y PET/CT, and compared with each other.

Results

DmNTL was < 50 Gy in the 3 groups, with a strong correlation in all population, albeit slightly lower in Metastases-SIR than HCC-SIR and HCC-Thera (CCC 0.8, 0.94 and 0.96, respectively). In tumoral liver, Dm was higher in HCC than metastases (159 ± 117 Gy versus 63 ± 31 Gy). 99mTc-MAA SPECT/CT proved to be a better indicator of Dm in HCC compared with metastases, with similar 99mTc-MAA-90Y concordance in resin and glass microspheres (CCC HCC-SIR 0.82, CCC HCC-Thera 0.82, and CCC Metastases-SIR 0.52).

Conclusion

99mTc-MAA SPECT/CT is a reasonably reliable tool for predicting the dose to the non-tumoral liver in both HCC and metastases, regardless of the type of microspheres. It is also fairly reliable for predicting the tumor dose in HCC, again regardless of the type of spheres, although individual variations are observed.

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Acknowledgments

We would like to express our gratitude toward the statistician (Laurence Seidel) and the referring physicians (Jean Delwaide, Anne Lamproye, Olivier Detry, Pierre Honoré, Marc Polus, Daniel Van Daele, Catherine Loly, Joelle Collignon, Elodie Gonne, Laurence Lousberg).

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Authors and Affiliations

  1. Division of Nuclear Medicine and Oncological Imaging, University Hospital of Liege, B35 Domaine Universitaire du Sart-Tilman, 4000, Liege, Belgium

    Alexandre Jadoul, Claire Bernard, Pierre Lovinfosse, Henri Lilet & Roland Hustinx

  2. Division of Radiology, University Hospital of Liege, Liege, Belgium

    Laurent Gérard & Olivier Cornet

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  1. Alexandre Jadoul
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  2. Claire Bernard
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  3. Pierre Lovinfosse
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Correspondence to Alexandre Jadoul.

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Conflict of interest

The CHU de Liège received speaker fees from Biocompatibles UK Ltd.

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All procedures were performed in accordance with the principles of the 1964 Declaration of Helsinki and its later amendments or comparable ethical standards. The study design and exemption from informed consent were approved by the Institutional Review Board of Liege University Hospital.

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This article is part of the Topical Collection on Oncology – Digestive tract

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Jadoul, A., Bernard, C., Lovinfosse, P. et al. Comparative dosimetry between 99mTc-MAA SPECT/CT and 90Y PET/CT in primary and metastatic liver tumors. Eur J Nucl Med Mol Imaging 47, 828–837 (2020). https://doi.org/10.1007/s00259-019-04465-7

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  • DOI: https://doi.org/10.1007/s00259-019-04465-7

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