■肝细胞癌是全世界最常见的恶性肿瘤之一。经动脉放射栓塞(TARE)包括选择性动脉内施用载有放射性化合物如钇-90(Y-90)的微球。传统上,在TARE期间,基于C臂的锥形束计算机断层扫描已被广泛使用。然而,血管计算机断层扫描(CT)是一种相对较新的模式,它结合了透视和fCT的优点。很少有文献详细介绍Y90TARE中血管CT的使用。
这是对2017年11月至2021年12月进行TARE手术的原发性肝癌病例的回顾性研究。在所有这些情况下使用基于玻璃的Y-90微球。所有病例均在混合血管CT套件中进行。进行计划后的单光子发射计算机断层扫描(SPECT-CT)确定了肺分流分数,并确认了病变的准确靶向。药物递送后,获得正电子发射断层扫描-计算机断层扫描(PET-CT)以确认Y-90颗粒的分布。技术上的成功,中位随访,客观反应率(ORR),无进展生存期(PFS),记录总生存期(OS)。
■在此期间,共有56名肝细胞癌患者接受了TARE,其中36例患者(30例男性和6例女性)接受了Y90TARE。肝硬化的病因包括非酒精性脂肪性肝炎(NASH)(11),丙型肝炎(HCV)(11),乙型肝炎(HBV)(9),代谢功能障碍和酒精相关性肝病(MetALD)(2),酒精性肝病(ALD)(1),隐源性(1),和自身免疫性肝炎(AIH)(1)。技术成功率为100%,中位随访时间为7个月(范围:1-32个月)。中位OS为15个月(范围10.73-19.27个月;95%CI),中位局部PFS为4个月(范围3.03-4.97个月;95%CI)。ORR(最佳回应,CR+PR)为58%。在这项研究中没有看到严重的并发症。
■TARE是所有阶段肝癌的可行选择,但在高级阶段更是如此。在TARE中使用血管CT有助于将颗粒精确递送至肿瘤并避免非目标栓塞。
UNASSIGNED: Hepatocellular carcinoma is one of the most common malignancies worldwide. Transarterial radioembolisation (TARE) involves selective intra-arterial administration of microspheres loaded with a radioactive compound like Yttrium-90 (Y-90). Conventionally, C-arm-based cone-beam computed tomography has been extensively used during TARE. However, angio-computed tomography (CT) is a relatively new modality which combines the advantages of both fluoroscopy and fCT. There is scarce literature detailing the use of angio-CT in Y90 TARE.
UNASSIGNED: This was a retrospective study of primary liver cancer cases in which the TARE procedure was done from November 2017 to December 2021. Glass-based Y-90 microspheres were used in all these cases. All the cases were performed in the hybrid angio-CT suite. A single photon emission computed tomography-computed comography (SPECT-CT) done postplanning session determined the lung shunt fraction and confirmed the accurate targeting of the lesion. Postdrug delivery, positron emission tomography-computed tomography (PET-CT) was obtained to confirm the distribution of the Y-90 particles. The technical success, median follow-up, objective response rate (ORR), progression-free survival (PFS), and overall survival (OS) were recorded.
UNASSIGNED: A total of 56 hepatocellular carcinoma patients underwent TARE during this period, out of which 36 patients (30 males and 6 females) underwent Y90 TARE. The aetiology of cirrhosis included non-alcoholic steatohepatitis (NASH) (11), hepatitis C (HCV) (11), hepatitis B (HBV) (9), metabolic dysfunction and alcohol-associated liver disease (MetALD) (2), alcoholic liver disease (ALD) (1), cryptogenic (1), and autoimmune hepatitis (AIH) (1). The technical success was 100 % and the median follow-up was 7 months (range: 1-32 months). The median OS was 15 months (range 10.73-19.27 months; 95 % CI) and the median local PFS was 4 months (range 3.03-4.97 months; 95 % CI). The ORR (best response, CR + PR) was 58 %. No major complications were seen in this study.
UNASSIGNED: TARE is a viable option for liver cancer in all stages, but more so in the advanced stages. The use of angio-CT in TARE aids in the precise delivery of the particles to the tumour and avoids non-target embolisation.