Y90肝放射栓塞的临床相关性和风险建模:肺分流分数根据成像方式、癌症类型和肿瘤大小的变化。

IF 2.6 3区 医学 Q2 PERIPHERAL VASCULAR DISEASE
M Allan Thomas, Tharun Alamuri, Ryan C Lee, Dan Giardina, John Karageorgiou, Naganathan Mani, Daniel A Braga, Christopher D Malone
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引用次数: 0

摘要

目的:验证基于肿瘤类型、肿瘤大小和影像学方式对肝脏90Y放射栓塞中肺分流分数(LSF)进行临床相关性和风险建模的假设。材料和方法:本研究回顾性分析了同一家医院34个月来354例连续病例。追踪癌症类型(HCC与非HCC)和最大肿瘤大小。LSF通过平面成像(LSFplanar)和三种不同校正的MAA-SPECT/CT方法在肺/肝边界(lsfffull, LSF2cm, LSFLeft)计算。分析5种肿瘤类型:1)HCC8 cm, 4) TIPS/血管侵犯,5)非hcc。结果:pplanar法、lsfffull法、LSF2cm法、LSFLeft法的中位LSF值分别为6.9、3.9、1.4、0.8%,差异有统计学意义。使用LSF2cm的病例分别占72%和19%,使用LSF2cm的病例仅占7%和2%。HCC8 cm的LSF较低(p≤0.003)。在hccp平面>为20%或LSF2cm>为5%。在所有方法中,TIPS/血管侵犯的病例保持最高的中位LSF (lsf平面:9.0%,LSF2cm: 2.8%), LSF >0 %和> %的病例百分比最高。结论:尽管不同的成像方式和校正方法存在显著差异,但LSF大小与肿瘤类型和肿瘤大小的趋势一致。观察临床相关LSF的相对危险度可以对不同类型肝肿瘤90Y放射栓塞进行建模。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Modeling Clinical Relevance and Risk in Yttrium-90 Radioembolization of the Liver: Lung Shunt Fraction Variability According to Imaging Modality, Cancer Type, and Tumor Size.

Purpose: To test the hypothesis that lung shunt fraction (LSF) in yttrium-90 (90Y) radioembolization (RE) of the liver can be modeled for clinical relevance and risk on the basis of cancer type, tumor size, and imaging modality.

Materials and methods: This was a retrospective analysis of 354 consecutive cases from a 34-month period at a single institution. Cancer type (hepatocellular carcinoma [HCC] vs non-HCC) and maximum tumor size were tracked. LSF was computed from planar imaging (LSFplanar) and 3 macroaggregated albumin-single photon emission computed tomography (SPECT)/computed tomography (CT) methods with different corrections at the lung/liver boundary (LSFFull, LSF2cm, and LSFLeft). Five tumor categories were analyzed: (a) HCC measuring <3 cm, (b) HCC measuring 3-8 cm, (c) HCC measuring >8 cm, (d) cases with transjugular intrahepatic portosystemic shunt (TIPS)/vascular invasion, and (e) non-HCC.

Results: Median LSF was significantly different (all P < .001) among LSFplanar, LSFFull, LSF2cm, and LSFLeft methods, with values of 6.9%, 3.9%, 1.4%, and 0.8%, respectively. There were 72% and 19% of cases with LSFplanar of >5% and >10%, respectively, but only 7% and 2% using LSF2cm. LSF was lower for HCC measuring <3 cm relative to HCC measuring 3-8 cm and >8 cm (P ≤ .003). In the <3-cm HCC group, there were no cases with LSFplanar > 20% or LSF2cm > 5%. Cases with TIPS/vascular invasion maintained the highest median LSF (LSFplanar, 9.0%; LSF2cm, 2.8%) and the highest percentages of cases with LSF values of >10% and >20% across all methods.

Conclusions: Despite significant variations with imaging modality and correction methods, consistent trends in LSF magnitude with cancer type and tumor size were still uncovered. The relative risk of observing clinically relevant LSF can be modeled for different liver tumor categories in 90Y-RE.

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来源期刊
CiteScore
4.30
自引率
10.30%
发文量
942
审稿时长
90 days
期刊介绍: JVIR, published continuously since 1990, is an international, monthly peer-reviewed interventional radiology journal. As the official journal of the Society of Interventional Radiology, JVIR is the peer-reviewed journal of choice for interventional radiologists, radiologists, cardiologists, vascular surgeons, neurosurgeons, and other clinicians who seek current and reliable information on every aspect of vascular and interventional radiology. Each issue of JVIR covers critical and cutting-edge medical minimally invasive, clinical, basic research, radiological, pathological, and socioeconomic issues of importance to the field.
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