Evidence map›Paper›PMID 31741021›Full record

ArticleEuropean journal of nuclear medicine and molecular imaging2020

The number of microspheres in Y90 radioembolization directly affects normal tissue radiation exposure.

Alexander S Pasciak, Godwin Abiola, Robert P Liddell, Nathan Crookston, Sepideh Besharati, Danielle Donahue, Richard E Thompson, Eric Frey, Robert A Anders, Matthew R Dreher and 1 more

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In one paragraph

Article in European journal of nuclear medicine and molecular imaging, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 37 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
37citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

37 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
  2. Holmium-166 radioembolisation dosimetry in HCC.European journal of nuclear medicine and molecular imaging · 2025
    Trial
  3. Safety and Efficacy ofJournal of nuclear medicine : official publication, Society of Nuclear Medicine · 2022
    Trial
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  19. Monte Carlo dosimetric analyses on the use ofPhysics in medicine and biology · 2024
    Article
  20. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

11 authors.

Alexander S PasciakSchool of Medicine, The Johns Hopkins Hospital, 733 N Broadway, Baltimore, MD, 21205, USA. alexander.pasciak@icloud.com.
Godwin AbiolaSchool of Medicine, The Johns Hopkins Hospital, 733 N Broadway, Baltimore, MD, 21205, USA.
Robert P LiddellDepartment of Radiology, Division of Vascular and Interventional Radiology, The Johns Hopkins Hospital, Baltimore, MD, USA.
Nathan CrookstonDepartment of Electrical Engineering, The Johns Hopkins University, Baltimore, MD, USA.
Sepideh BesharatiDepartment of Pathology, The Johns Hopkins University, Baltimore, MD, USA.
Danielle DonahueMouse Imaging Facility, National Institutes of Health, Bethesda, MD, USA.
Richard E ThompsonDepartment of Biostatistics, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.
Eric FreyRadiological Physics Division, Russell H Morgan Department of Radiology and Radiological Science, The Johns Hopkins Hospital, Baltimore, MD, USA.
Robert A AndersDepartment of Pathology, The Johns Hopkins University, Baltimore, MD, USA.
Matthew R DreherBiocompatibles UK Ltd, BTG International group company, Farnham, Surrey, UK.
Clifford R WeissDepartment of Radiology, Division of Vascular and Interventional Radiology, The Johns Hopkins Hospital, Baltimore, MD, USA.

Funding

Translational Research Enhancement CoreP30DK089502 · NIDDK · JOHNS HOPKINS UNIVERSITY · PI ZACHOS, NICHOLAS CONSTANTINE · 2011 to 2020
$12.0M
NIDDK NIH HHS P30 DK089502
6 · The paper itself

Abstract

purposeIn Y90 radioembolization, the number of microspheres infused varies by more than a factor of 20 over the shelf-life of the glass radioembolization device. We investigated the effect of the number of Y90 microspheres on normal liver tissue.

methodHealthy pigs received lobar radioembolization with glass Y90 microspheres at 4, 8, 12, and 16 days post-calibration, representing a > 20× range in the number of microspheres deposited per milliliter in tissue. Animals were survived for 1-month post-treatment and the livers were explanted and scanned on a micro CT system to fully characterize the microscopic distribution of individual microspheres. A complete 3D microdosimetric evaluation of each liver was performed with a spatially correlated analysis of histopathologic effect.

resultsThrough whole-lobe microscopic identification of each microsphere, a consistent number of microspheres per sphere cluster was found at 4, 8, and 12 days postcalibration, despite an 8-fold increase in total microspheres infused from days 4 to 12. The additional microspheres instead resulted in more clusters formed and, therefore, a more homogeneous microscopic absorbed dose. The increased absorbed-dose homogeneity resulted in a greater volume fraction of the liver receiving a potentially toxic absorbed dose based on radiobiologic models. Histopathologic findings in the animals support a possible increase in normal liver toxicity in later treatments with more spheres (i.e., ≥ day 12) compared to early treatments with less spheres (i.e., ≤ day 8).

conclusionThe microdosimetric evidence presented supports a recommendation of caution when treating large volumes (e.g., right lobe) using glass

Indexed as

BrachytherapyEmbolization, TherapeuticLiver NeoplasmsRadiation ExposureAnimalsMicrospheresSwineYttrium RadioisotopesYttrium RadioisotopesDosimetryHepatocellular carcinomaHepatotoxicitySIRTY90

Identifiers

PMID31741021

What OpenQuestion holds

Textmetadata
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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.