Trial reportEuropean journal of nuclear medicine and molecular imaging2014
(⁹⁹m)Tc-MAA overestimates the absorbed dose to the lungs in radioembolization: a quantitative evaluation in patients treated with ¹⁶⁶Ho-microspheres.
Trial report in European journal of nuclear medicine and molecular imaging, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 54 papers, 2 of them syntheses that pooled it.
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Who cites it
54 citing papers in PubMed, 2 syntheses or guidelines pooled it, 138 citations in OpenAlex.
- EANM procedure guideline for the treatment of liver cancer and liver metastases with intra-arterial radioactive compounds.European journal of nuclear medicine and molecular imaging · 2022Guideline
- To 1000 Gy and back again: a systematic review on dose-response evaluation in selective internal radiation therapy for primary and secondary liver cancer.European journal of nuclear medicine and molecular imaging · 2021Pooled it
- Holmium-166 radioembolisation dosimetry in HCC.European journal of nuclear medicine and molecular imaging · 2025Trial
- Safety and Efficacy ofJournal of nuclear medicine : official publication, Society of Nuclear Medicine · 2022Trial
- Accuracy and Safety of Scout Dose Resin Yttrium-90 Microspheres for Radioembolization Therapy Treatment Planning: A Prospective Single-Arm Clinical Trial.Journal of vascular and interventional radiology : JVIR · 2022Trial
- Additional hepaticBMC gastroenterology · 2018Trial
- Article
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- Investigation of the Partial Volume Effect in Pre-Dosimetry of Liver Tumors forMolecular imaging and radionuclide therapy · 2025Article
- Assessment and clinical relevance of pulmonary shunt onEJNMMI physics · 2025Article
- Lung shunting and radiation pneumonitis after holmium-166 TARE: a case study.EJNMMI reports · 2025Article
- Optimizing Yttrium-90 Radioembolization Dosimetry for Hepatocellular Carcinoma: A Korean Perspective.Korean journal of radiology · 2025Review
- Review
- Evaluation of long axial field-of-view (LAFOV) PET/CT for post-treatment dosimetry in Yttrium-90 radioembolization of liver tumors: a comparative study with conventional SPECT imaging.European journal of nuclear medicine and molecular imaging · 2025Article
- Article
- Gamma camera imaging characteristics ofEJNMMI physics · 2024Article
- Lung Mean Dose Prediction in Transarterial Radioembolization (TARE): Superiority of [Cardiovascular and interventional radiology · 2024Article
- Safety and efficacy of Holmium-166 selective internal radiotherapy of primary and secondary liver cancer confirmed by real-world data.Frontiers in oncology · 2024Article
- Holmium-166 Transarterial Radioembolization for the Treatment of Intrahepatic Cholangiocarcinoma: A Case Series.Cancers · 2023Article
- Dose finding study for unilobar radioembolization using holmium-166 microspheres to improve resectability in patients with HCC: the RALLY protocol.BMC cancer · 2023Article
Corrections and comments
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Authors and funding
9 authors at 3 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
purposeRadiation pneumonitis is a rare but serious complication of radioembolic therapy of liver tumours. Estimation of the mean absorbed dose to the lungs based on pretreatment diagnostic (99m)Tc-macroaggregated albumin ((99m)Tc-MAA) imaging should prevent this, with administered activities adjusted accordingly. The accuracy of (99m)Tc-MAA-based lung absorbed dose estimates was evaluated and compared to absorbed dose estimates based on pretreatment diagnostic (166)Ho-microsphere imaging and to the actual lung absorbed doses after (166)Ho radioembolization.
methodsThis prospective clinical study included 14 patients with chemorefractory, unresectable liver metastases treated with (166)Ho radioembolization. (99m)Tc-MAA-based and (166)Ho-microsphere-based estimation of lung absorbed doses was performed on pretreatment diagnostic planar scintigraphic and SPECT/CT images. The clinical analysis was preceded by an anthropomorphic torso phantom study with simulated lung shunt fractions of 0 to 30 % to determine the accuracy of the image-based lung absorbed dose estimates after (166)Ho radioembolization.
resultsIn the phantom study, (166)Ho SPECT/CT-based lung absorbed dose estimates were more accurate (absolute error range 0.1 to -4.4 Gy) than (166)Ho planar scintigraphy-based lung absorbed dose estimates (absolute error range 9.5 to 12.1 Gy). Clinically, the actual median lung absorbed dose was 0.02 Gy (range 0.0 to 0.7 Gy) based on posttreatment (166)Ho-microsphere SPECT/CT imaging. Lung absorbed doses estimated on the basis of pretreatment diagnostic (166)Ho-microsphere SPECT/CT imaging (median 0.02 Gy, range 0.0 to 0.4 Gy) were significantly better predictors of the actual lung absorbed doses than doses estimated on the basis of (166)Ho-microsphere planar scintigraphy (median 10.4 Gy, range 4.0 to 17.3 Gy; p < 0.001), (99m)Tc-MAA SPECT/CT imaging (median 2.5 Gy, range 1.2 to 12.3 Gy; p < 0.001), and (99m)Tc-MAA planar scintigraphy (median 5.5 Gy, range 2.3 to 18.2 Gy; p < 0.001).
conclusionIn clinical practice, lung absorbed doses are significantly overestimated by pretreatment diagnostic (99m)Tc-MAA imaging. Pretreatment diagnostic (166)Ho-microsphere SPECT/CT imaging accurately predicts lung absorbed doses after (166)Ho radioembolization.
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