PMID- 36958669
OWN - NLM
STAT- MEDLINE
DCOM- 20230630
LR  - 20231027
IS  - 1535-7732 (Electronic)
IS  - 1051-0443 (Linking)
VI  - 34
IP  - 7
DP  - 2023 Jul
TI  - Yttrium-90 Radiation Segmentectomy of Hepatocellular Carcinoma: A Comparative 
      Study of the Effectiveness, Safety, and Dosimetry of Glass-Based versus 
      Resin-Based Microspheres.
PG  - 1226-1234
LID - S1051-0443(23)00216-6 [pii]
LID - 10.1016/j.jvir.2023.02.030 [doi]
AB  - PURPOSE: To evaluate the differences in safety, effectiveness, and dosimetry 
      between glass-based and resin-based ablative yttrium-90 ((90)Y) transarterial 
      radioembolization (TARE) of hepatocellular carcinoma (HCC). MATERIALS AND 
      METHODS: Using the modified Response Evaluation Criteria in Solid Tumors and 
      Common Terminology Criteria for Adverse Events, both tumor response and adverse 
      events (AEs) were assessed at 3 months after (90)Y-TARE. Post procedure 
      (90)Y-bremsstrahlung single-photon emission computed tomography/computed 
      tomography voxel-based dosimetry analysis was used to create tumor dose (TD) and 
      normal tissue dose (NTD) volume histograms, and to calculate tumor particle 
      loading and specific activity. The TD and NTD receiver operating characteristic 
      curves evaluated the dose threshold able to predict objective (partial or 
      complete) and complete tumor responses in addition to any-grade and grade >/=3 AE 
      incidences. The chi-square test and Student t-test were used to assess variable 
      differences where appropriate. RESULTS: Between 2019 and 2020, 81 patients with 
      HCC (20 in the resin-based cohort and 61 in the glass-based cohort) underwent 
      ablative (90)Y-TARE. The resin-based cohort had more males (89% vs 65%, P = .03), 
      lower tumor-to-normal ratio (1.81 +/- 0.39 vs 2.22 +/- 0.94, P = .03), higher tumor 
      particle loading (40,172 particles/mL +/- 28,039 vs 17,081 particles/mL +/- 12,555, 
      P = .0001), lower specific activity (158 Bq/particle +/- 3 vs 1,058 Bq/particle +/- 
      331, P = .001), and lower mean TD (308 Gy +/- 210 vs 794 Gy +/- 523, P = .0002) than 
      the glass-based cohort. No significant differences in baseline characteristics or 
      posttreatment AEs were noted. The overall objective and complete response rates 
      were 85% (95% resin-based vs 82% glass-based; P = .1) and 65% (95% resin-based vs 
      56% glass-based; P = .003), respectively. The mean TD thresholds able to predict 
      the objective and complete responses were 176 Gy and 247 Gy for resin-based 
      radioembolization and 290 Gy and 481 Gy for glass-based radioembolization, 
      respectively. A maximum NTD of 999 Gy predicted any-grade AEs in glass-based 
      ablative (90)Y-TARE. CONCLUSIONS: Compared with glass-based ablative (90)Y-TARE, 
      resin-based ablative (90)Y-TARE can offer comparable safety and effectiveness 
      profiles for patients with HCC. The impact of the significantly different tumor 
      particle loading, particle specific activities, and delivered TDs on tumor 
      response outcomes merits further investigation.
CI  - Copyright (c) 2023 SIR. Published by Elsevier Inc. All rights reserved.
FAU - Villalobos, Alexander
AU  - Villalobos A
AD  - Department of Radiology and Imaging Sciences, Emory University School of 
      Medicine, Atlanta, Georgia. Electronic address: avillalobos@emory.edu.
FAU - Arndt, Linzi
AU  - Arndt L
AD  - Department of Radiology and Imaging Sciences, Emory University School of 
      Medicine, Atlanta, Georgia.
FAU - Cheng, Bernard
AU  - Cheng B
AD  - Department of Radiology and Imaging Sciences, Emory University School of 
      Medicine, Atlanta, Georgia.
FAU - Dabbous, Howard
AU  - Dabbous H
AD  - Department of Radiology and Imaging Sciences, Emory University School of 
      Medicine, Atlanta, Georgia.
FAU - Loya, Mohammed
AU  - Loya M
AD  - Department of Radiology and Imaging Sciences, Emory University School of 
      Medicine, Atlanta, Georgia.
FAU - Majdalany, Bill
AU  - Majdalany B
AD  - Department of Radiology and Imaging Sciences, Emory University School of 
      Medicine, Atlanta, Georgia.
FAU - Bercu, Zachary
AU  - Bercu Z
AD  - Department of Radiology and Imaging Sciences, Emory University School of 
      Medicine, Atlanta, Georgia.
FAU - Kokabi, Nima
AU  - Kokabi N
AD  - Department of Radiology and Imaging Sciences, Emory University School of 
      Medicine, Atlanta, Georgia.
LA  - eng
PT  - Journal Article
DEP - 20230321
PL  - United States
TA  - J Vasc Interv Radiol
JT  - Journal of vascular and interventional radiology : JVIR
JID - 9203369
RN  - 1K8M7UR6O1 (Yttrium-90)
RN  - 0 (Yttrium Radioisotopes)
SB  - IM
CIN - J Vasc Interv Radiol. 2023 Jul;34(7):1235-1236. PMID: 36958670
CIN - J Vasc Interv Radiol. 2023 Oct;34(10):1844-1846. PMID: 37315682
MH  - Male
MH  - Humans
MH  - *Carcinoma, Hepatocellular/diagnostic imaging/radiotherapy/drug therapy
MH  - *Liver Neoplasms/diagnostic imaging/radiotherapy/drug therapy
MH  - Microspheres
MH  - Pneumonectomy
MH  - Yttrium Radioisotopes/adverse effects
MH  - *Embolization, Therapeutic/adverse effects/methods
MH  - Retrospective Studies
EDAT- 2023/03/24 06:00
MHDA- 2023/06/30 06:42
CRDT- 2023/03/23 20:32
PHST- 2022/06/17 00:00 [received]
PHST- 2023/01/29 00:00 [revised]
PHST- 2023/02/02 00:00 [accepted]
PHST- 2023/06/30 06:42 [medline]
PHST- 2023/03/24 06:00 [pubmed]
PHST- 2023/03/23 20:32 [entrez]
AID - S1051-0443(23)00216-6 [pii]
AID - 10.1016/j.jvir.2023.02.030 [doi]
PST - ppublish
SO  - J Vasc Interv Radiol. 2023 Jul;34(7):1226-1234. doi: 10.1016/j.jvir.2023.02.030. 
      Epub 2023 Mar 21.