Hepatic tumor to normal tissue activity ratio comparison of two primary disease cohorts: Hepatocellular carcinoma (HCC) vs neuroendocrine disease (ND) with metastatic hepatic tumor

Objectives Radioembolization using Yittrium-90 (Y-90) microspheres treatment for unresectable hepatic tumor requires image analysis using angiography and [Tc-99m] macro aggregated albumin (MAA) administered through a hepatic artery. The purpose of this research is to determine if the tumor to normal activity ratios (TN) from MAA SPECT varied with tumor vascular density by comparing the TN from two primary disease cohorts. Patients with hepatocelluar carcinoma (HCC) tumor have relatively less vascular density compared to the hepatic tumor of patient with neuroendocrine disease (ND) when viewed with angiography.

Methods Fifty-five patients with HCC and 22 patients with ND with metastatic hepatic tumor were administered approximately 148 MBq of MAA. Following the administration, static and SPECT images were obtained. TN were calculated using the count data from region of interest (ROI) drawn on SPECT images and was calculated as the counts per voxel for an iso-contour ROI based on the FWHM from the tumor divided by the counts per voxel for adjacent normal tissue. The TN from the HCC group was compared to the TN from the ND group.

Results The average TN from the HCC cohort was 5.2 ± 4.1 (range of 1.2 and 20). The average TN from ND cohort was 4.2 ± 3.9 (range of 2.3 and 20.3). The difference between the two cohorts is not statistically significant (p-value = 0.19).

Conclusions In conclusion, TN within the liver of patients with HCC did not differ significantly from the TN found from patients with metastatic ND