RT Journal Article
SR Electronic
T1 Biologic Dosimetry of <sup>188</sup>Re-HDD/Lipiodol Versus <sup>131</sup>I-Lipiodol Therapy in Patients with Hepatocellular Carcinoma
JF Journal of Nuclear Medicine
JO J Nucl Med
FD Society of Nuclear Medicine
SP 612
OP 618
VO 45
IS 4
A1 Kim De Ruyck
A1 Bieke Lambert
A1 Klaus Bacher
A1 Filip Gemmel
A1 Filip De Vos
A1 Anne Vral
A1 Leo de Ridder
A1 Rudi A. Dierckx
A1 Hubert Thierens
YR 2004
UL http://jnm.snmjournals.org/content/45/4/612.abstract
AB 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 β-emitter, has a shorter half-life than 131I, and has only low-intensity γ-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.