ArticleEuropean journal of nuclear medicine and molecular imaging2025
Radioembolization of hepatocellular carcinoma with
Article in European journal of nuclear medicine and molecular imaging, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
purpose
methodsWe retrospectively analysed lesion-by-lesion response at the best response time using the mRECIST criterion. Two chronologically sequential cohorts of patients were compared. Both cohorts were planned and treated with lobar administration, with exactly the same methodology, except for the post-calibration decay interval (Administration day: day 4 vs day 8). Infiltrative lesions and those with additional treatments post-radioembolization were excluded. To compare efficacy at the same TAD, we plotted TCP curves as a function of TAD and stratified TCP by lesion mass (M), using an arbitrary 50 g cut-off (equivalent to a 4.6 cm diameter). On fully perfused lesions, TCP was analyzed also as function of ρ and mass. We then conducted univariate ROC and multivariate analysed to assess response impact based on TAD, ρ, a
resultsA total of 94 patients with 150 lesions were analyzed. TCP (for TAD up to 600 Gy) was significantly higher for the 59 lesions treated on Day 4 compared to the 91 lesions treated on Day 8, though the difference diminished at higher TAD values. In fully perfused lesions, TCP plateaued at 344 Gy and 160 Gy for lesions treated on Day 8 and Day 4 respectively. ROC analysis for fully perfused lesions showed poor AUC values for CR + PR versus SD + PD: 0.62, p = 0.01 for a DISCUSSION: Our findings on TCP confirmed our preliminary unpublished studies from a different lesion cohort assessed by two independent radiologists. Additionally, our results align with recent experimental histological studies on complete pathological necrosis (CPN) in explanted liver samples after neoadjuvant segmentectomy prior to liver transplantation. However, our data and the CPN findings contrast with previously published simulations based purely on physical parameters (dose-volume histograms at microscopic scale). No explanation is currently available for this discrepancy.
conclusionWhen considering OR probability, administration of
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