Increased Voxel-Based Y90 Radioembolization Dose to Hepatocellular Carcinoma Improves Imaging Response.

IF 2.8 3区医学 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS

CardioVascular and Interventional Radiology Pub Date : 2025-03-10 DOI:10.1007/s00270-025-04001-1

Shanmukha Srinivas, Kurt Pianka, Helena D Rockwell, Akhilesh Yeluru, Joy Liau, Ashwin Ganesh, Jeet Minocha, Cairine McNamee, Steven C Rose, Kathryn Fowler, Zachary T Berman

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引用次数: 0

Abstract

Purpose: To evaluate the relationship between radioembolization tumor dose and imaging response for hepatocellular carcinoma (HCC) treated with radioembolization.

Materials and methods: Retrospective single-institution evaluation of treatment-naïve patients with HCC who underwent TARE between November 2017 and September 2020. Dose-volume histograms (DVHs) were calculated from post 90Y single-photon emission computed tomography. Cross-sectional imaging was obtained at 3 months after radioembolization and evaluated by three blinded abdominal radiologists.

Results: Forty-one patients underwent radioembolization who met the inclusion criteria. Median age was 67 years (range 41-84); 11 were female. At 3 months, 23/41 (56%) had complete response (CR), 9/41 (22%) had partial response (PR), and 8/41 (20%) had stable disease (SD) by mRECIST criteria. DVH analysis demonstrated that increased dose to different tumor volumes was predictive of a complete imaging response at 3 months (p < 0.05 for all). Receiver operating characteristic (ROC) analysis demonstrated a dose threshold of 687 Gy to 95% of the tumor volume resulted in the highest area under curve (AUC) at 0.86 (CI 0.73-0.95) and a positive predictive value (PPV) of 82% to predict complete response by mRECIST criteria.

Conclusion: Voxel-based dosimetry demonstrates that several dose thresholds are predictive of a complete imaging response by mRECIST criteria. A threshold dose of 687 Gy to at least 95% of the tumor volume led to the highest accuracy in predicting complete response by mRECIST criteria.

Level of evidence: Level 3, Cohort Study.

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来源期刊

CardioVascular and Interventional Radiology 医学-核医学

CiteScore

5.50

自引率

13.80%

发文量

306

审稿时长

3-8 weeks

期刊介绍： CardioVascular and Interventional Radiology (CVIR) is the official journal of the Cardiovascular and Interventional Radiological Society of Europe, and is also the official organ of a number of additional distinguished national and international interventional radiological societies. CVIR publishes double blinded peer-reviewed original research work including clinical and laboratory investigations, technical notes, case reports, works in progress, and letters to the editor, as well as review articles, pictorial essays, editorials, and special invited submissions in the field of vascular and interventional radiology. Beside the communication of the latest research results in this field, it is also the aim of CVIR to support continuous medical education. Articles that are accepted for publication are done so with the understanding that they, or their substantive contents, have not been and will not be submitted to any other publication.