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Purpose <p>To evaluate the relationship between radioembolization tumor dose and imaging response for hepatocellular carcinoma (HCC) treated with radioembolization.</p> Materials and Methods <p>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&#xa0;months after radioembolization and evaluated by three blinded abdominal radiologists.</p> Results <p>Forty-one patients underwent radioembolization who met the inclusion criteria. Median age was 67&#xa0;years (range 41–84); 11 were female. At 3&#xa0;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&#xa0;months (<i>p</i> &lt; 0.05 for all). Receiver operating characteristic (ROC) analysis demonstrated a dose threshold of 687&#xa0;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.</p> Conclusion <p>Voxel-based dosimetry demonstrates that several dose thresholds are predictive of a complete imaging response by mRECIST criteria. A threshold dose of 687&#xa0;Gy to at least 95% of the tumor volume led to the highest accuracy in predicting complete response by mRECIST criteria.</p> Level of Evidence <p>Level 3, Cohort Study.</p>

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

  • 期刊论文

  • 发表日期：

    2025年3月10日

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  • 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

摘要

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.