Abstract：
Our objective was to compare 3 different therapeutic particles used for radioembolization in locally advanced intrahepatic cholangiocarcinoma. Methods: 90Y-glass, 90Y-resin, and 166Ho-labeled poly(l-lactic acid) microsphere prescribed activity was calculated as per manufacturer recommendations. Posttreatment quantitative 90Y PET/CT and quantitative 166Ho SPECT/CT were used to determine tumor-absorbed dose, whole-normal-liver-absorbed dose, treated-normal-liver-absorbed dose, tumor-to-nontumor ratio, lung-absorbed dose, and lung shunt fraction. Response was assessed using RECIST 1.1 and the [18F]FDG PET-based change in total lesion glycolysis. Hepatotoxicity was assessed using the radioembolization-induced liver disease classification. Results: Six 90Y-glass, 8 90Y-resin, and 7 166Ho microsphere patients were included for analysis. The mean administered activity was 2.6 GBq for 90Y-glass, 1.5 GBq for 90Y-resin, and 7.0 GBq for 166Ho microspheres. Tumor-absorbed dose and treated-normal-liver-absorbed dose were significantly higher for 90Y-glass than for 90Y-resin and 166Ho microspheres (mean tumor-absorbed dose, 197 Gy for 90Y-glass vs. 73 Gy for 90Y-resin and 50 Gy for 166Ho; mean treated-normal-liver-absorbed dose, 79 Gy for 90Y-glass vs. 37 Gy for 90Y-resin and 31 Gy for 166Ho). The whole-normal-liver-absorbed dose and tumor-to-nontumor ratio did not significantly differ between the particles. All patients had a lung-absorbed dose under 30 Gy and a lung shunt fraction under 20%. The 3 groups showed similar toxicity and response according to RECIST 1.1 and [18F]FDG PET-based total lesion glycolysis changes. Conclusion: The therapeutic particles used for radioembolization differed from each other and showed significant differences in absorbed dose, whereas toxicity and response were similar for all groups. This finding emphasizes the need for separate dose constraints and dose targets for each particle.
摘要：
我们的目的是比较3种用于局部晚期肝内胆管癌放射栓塞的不同治疗颗粒。方法：90Y玻璃，90Y-树脂,和166Ho标记的聚（1-乳酸）微球规定的活性根据制造商的建议计算。治疗后定量90YPET/CT和定量166HoSPECT/CT用于确定肿瘤吸收剂量，整个正常肝脏吸收剂量，正常肝脏吸收剂量，肿瘤与非肿瘤的比率，肺吸收剂量，和肺分流部分。使用RECIST1.1和基于[18F]FDGPET的总病变糖酵解变化评估反应。使用放射性栓塞诱导的肝病分类评估肝毒性。结果：六个90Y玻璃，890Y树脂，纳入7例166Ho微球患者进行分析。90Y玻璃的平均给药活性为2.6GBq，90Y树脂为1.5GBq，和7.0GBq的166Ho微球。90Y玻璃的肿瘤吸收剂量和正常肝脏吸收剂量显着高于90Y树脂和166Ho微球（平均肿瘤吸收剂量，197Gy适用于90Y玻璃与90Y树脂为73Gy，166Ho为50Gy；平均治疗正常肝脏吸收剂量，90Y玻璃与79Gy90Y树脂为37Gy，166Ho为31Gy）。颗粒之间的整个正常肝脏吸收剂量和肿瘤与非肿瘤之比没有显着差异。所有患者的肺吸收剂量均低于30Gy，肺分流率低于20％。根据RECIST1.1和基于[18F]FDGPET的总病变糖酵解变化，3组显示出相似的毒性和反应。结论：用于放射性栓塞的治疗颗粒彼此不同，并且在吸收剂量上表现出明显差异，而所有组的毒性和反应相似。这一发现强调了每个颗粒需要单独的剂量约束和剂量目标。
