HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Figures Only Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by De Ruyck, K. Articles by Thierens, H. Search for Related Content PubMed PubMed Citation Articles by De Ruyck, K. Articles by Thierens, H.

Biologic Dosimetry of ¹⁸⁸Re-HDD/Lipiodol Versus ¹³¹I-Lipiodol Therapy in Patients with Hepatocellular Carcinoma

¹ Department of Anatomy, Embryology, Histology, and Medical Physics, Ghent University, Gent, Belgium
² Division of Nuclear Medicine, Ghent University Hospital, Gent, Belgium

One approach to treatment of primary hepatocellular carcinoma (HCC) is intraarterial injection of ¹³¹I-lipiodol. Although clinical results have been positive, the therapy can be improved by using ¹⁸⁸Re instead of ¹³¹I as the radionuclide. ¹⁸⁸Re is a high-energy ß-emitter, has a shorter half-life than ¹³¹I, and has only low-intensity -rays in its decay. The present study compared the cytotoxic effect of the radionuclide therapy in HCC patients treated with ¹³¹I-lipiodol and ¹⁸⁸Re-4-hexadecyl 2,2,9,9-tetramethyl-4,7-diaza-1,10-decanethiol (HDD)/lipiodol. To this end, dicentric chromosomes (DCs) were scored in metaphase spreads of peripheral blood cultures. The equivalent total-body dose was deduced from the DC yields using an in vitro dose-response curve. Methods: Twenty ¹³¹I-lipiodol treatments and 11 ¹⁸⁸Re-HDD/lipiodol treatments were performed on, respectively, 16 and 7 patients with inoperable HCC. Patients received a mean activity of 1.89 GBq of ¹³¹I-lipiodol or 3.56 GBq of ¹⁸⁸Re-HDD/lipiodol into the liver artery by catheterization. For each patient, a blood sample was taken during the week before therapy. A blood sample was also taken 7 and 14 d after administration for the patients treated with ¹³¹I-lipiodol and 1 or 2 d after administration for the patients treated with ¹⁸⁸Re-HDD/lipiodol. Results: The mean DC yield of ¹⁸⁸Re-HDD/lipiodol therapy (0.087 DCs per cell) was significantly lower than that of ¹³¹I-lipiodol therapy (0.144 DCs per cell) for the administered activities. Corresponding equivalent total-body doses were 1.04 Gy for ¹⁸⁸Re-HDD/lipiodol and 1.46 Gy for ¹³¹I-lipiodol. Data analysis showed that, in comparison with ¹³¹I-lipidol, ¹⁸⁸Re-HDD/lipiodol yielded a smaller cytotoxic effect and a lower radiation exposure for an expected higher tumor-killing effect. Conclusion: ¹⁸⁸Re is a valuable alternative for ¹³¹I in the treatment of HCC with radiolabeled lipiodol, and a dose escalation study for ¹⁸⁸Re-HDD/lipiodol therapy is warranted.

Key Words: ¹³¹I-lipiodol therapy • ¹⁸⁸Re-HDD/lipiodol therapy • biologic dosimetry • dicentric chromosome assay

This article has been cited by other articles:

				B. Lambert, K. Bacher, L. Defreyne, F. Gemmel, H. Van Vlierberghe, J. M. Jeong, R. A. Dierckx, C. Van de Wiele, H. Thierens, and F. De Vos 188Re-HDD/Lipiodol Therapy for Hepatocellular Carcinoma: A Phase I Clinical Trial J. Nucl. Med., January 1, 2005; 46(1): 60 - 66. [Abstract] [Full Text] [PDF]