Prior ablation and progression of disease correlate with higher tumor-to-normal liver 99m Tc-MAA uptake ratio in hepatocellular carcinoma

Factors affecting tumor-to-normal tissue ratio (T:N) have implications for patient selection, dosimetry, and outcomes when considering radioembolization for HCC. This study sought to evaluate patient, disease specific, and technical parameters that predict T:N as measured on planning pre- Y radioemb...

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Published inAbdominal radiology (New York) Vol. 48; no. 2; p. 752
Main Authors Patel, Mikin V, McNiel, David, Brunson, Christopher, Kuo, Phillip H, Hennemeyer, Charles T, Woodhead, Gregory, McGregor, Hugh
Format Journal Article
LanguageEnglish
Published United States 01.02.2023
Subjects
Carcinoma, Hepatocellular - pathology
Disease Progression
Embolization, Therapeutic - methods
Humans
Liver Neoplasms - pathology
Retrospective Studies
Technetium Tc 99m Aggregated Albumin
Yttrium Radioisotopes
Interventional oncology
Hepatocellular carcinoma
Dosimetry
Radioembolization
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Summary:Factors affecting tumor-to-normal tissue ratio (T:N) have implications for patient selection, dosimetry, and outcomes when considering radioembolization for HCC. This study sought to evaluate patient, disease specific, and technical parameters that predict T:N as measured on planning pre- Y radioembolization Tc-MAA scintigraphy for hepatocellular carcinoma (HCC). Tc-MAA hepatic angiography procedures with SPECT/CT over a 4-year period were reviewed. Data recorded included patient demographics, details of underlying liver disease, tumor size, history of prior treatments for HCC and technical parameters from angiography. Anatomic-based segmentation was performed in 93 cases for measurement of tumor and perfused liver volumes and SPECT counts. T:N were calculated and correlated with collected variables. Mean calculated T:N was 2.52. History of prior ablation was significantly correlated with higher T:N (mean 3.39 vs 2.24, p = 0.003). Cases in which mapping was being performed for treatment of disease progression was significantly correlated with higher T:N (mean 3.35 vs 2.14, p = 0.001). Larger tumor size trended toward lower T:N (p = 0.052). Patients with history of ablation and those undergoing treatment for disease progression have higher T:N and, therefore, could be considered for radioembolization preferentially over alternative treatments.
ISSN:2366-0058