RT Journal Article
SR Electronic
T1 Intraarterial Yttrium-90 Microsphere Therapy for Primary and Secondary Liver Tumors :A-7-year Experience of a Single Institution.
JF Journal of Nuclear Medicine
JO J Nucl Med
FD Society of Nuclear Medicine
SP 474
OP 474
VO 57
IS supplement 2
A1 Fani Bozkurt
A1 Bilge SALANCI
A1 Bora PEYNIRCIOGLU
A1 Gonca ELDEM
A1 Barbaros CIL
A1 Omer UGUR
YR 2016
UL http://jnm.snmjournals.org/content/57/supplement_2/474.abstract
AB 474Objectives Intraarterial Yttrim-90 (Y-90) microsphere therapy serves as an efficient therapeutic option for unresectable primary and metastatic liver tumors. It has the major advantage of providing high radiation dose to tumor tissue while protecting the normal liver cells from radiation hazard due to different blood supplies of liver tumors and normal liver paranchyme. The aim of this study was to present the results of a single university hospital in a time period of 7 years.Methods A total of 304 procedures in 246 patients were performed between April 2008 and December 2015. All patients had unresectable liver tumors, with the diagnosis of primary hepatic tumors in 36%, and metastatic liver tumors in 64%. Appropriateness criteria for this treatment were as follows: Patient with inoperable primary or secondary liver tumors with serum levels of total Bilirubin lower than 2 mg/dl, Albumin greater than 3 gr/dl and ALT and AST within 5 times the upper limit.After the initial acceptance, patients underwent hepatic angiography where any accessory branches that shunt blood from the tumor bed to gastrointestinal region were coiled. During this procedure, 5 mCi of Tc-99m-macroaggregated Albumin (MAA) for hepatic artery perfusion scintigraphy was injected intraarterially. Planar and SPECT or SPECT/CT imaging as well as quantitative analysis were done. Either resin or glass microspheres were given to each patient and the therapeutic dose was calculated according to particular type of microsphere as proposed in the literature. After dose administration, patients underwent posttherapeutic Brehmstrahlung imaging at Nuclear Medicine. Routine follow-up included weekly liver function tests, complete blood counts and tumor markers as well as PET/CT one month after therapy for early therapy response assessment.Results Resin and glass microspheres were given to 52% and 48% of patients respectively. The median Y-90 microsphere dose was 1,23 GBq and 2,72 GBq for resin and glass respectively. None of the patients developed cholecystitis or lung fibrosis. The most common post-treatment complaints were fatigue, mild fever and abdominal pain, which were self-limited. According to early PET/CT, 25% patients showed complete and 54% showed partial metabolic response which resulted with an objective response rate of 79% , while 9% showed stable disease and 12% progression.Conclusions Intraarterial treatment with both resin and glass Y-90 microspheres seems to be an effective and safe therapy regimen for patients with unresectable primary and metastatic liver tumors. PET/CT performs well to assess early therapy response.