Evidence map›Paper›PMID 42446581›Full record

ArticleEuropean journal of nuclear medicine and molecular imaging2026

Effects of dose heterogeneity on response and toxicity after

Huan Xi, Xinlin Zheng, Andor W J M Glaudemans, Joyce van Sluis, Simeon J S Ruiter, Robbert J de Haas, G Matthijs Kater, Oleksandra V Ivashchenko, Walter Noordzij

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In one paragraph

Article in European journal of nuclear medicine and molecular imaging, 2026. 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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0cells of the map it votes in
0citing papers in PubMed
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1 · What the graph read from it

What it found

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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

0 citing papers in PubMed.

No citing paper in PubMed yet.

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

9 authors.

Huan XiDepartment of Nuclear Medicine and Molecular Imaging, University of Groningen, University Medical Centre Groningen, Groningen, The Netherlands. h.xi@umcg.nl.ORCID http://orcid.org/0009-0000-7623-8451
Xinlin ZhengDepartment of Nuclear Medicine and Molecular Imaging, University of Groningen, University Medical Centre Groningen, Groningen, The Netherlands.
Andor W J M GlaudemansDepartment of Nuclear Medicine and Molecular Imaging, University of Groningen, University Medical Centre Groningen, Groningen, The Netherlands.
Joyce van SluisDepartment of Nuclear Medicine and Molecular Imaging, University of Groningen, University Medical Centre Groningen, Groningen, The Netherlands.
Simeon J S RuiterDepartment of Hepato-Pancreato-Biliary Surgery and Liver Transplantation, University of Groningen, University Medical Centre Groningen, Groningen, The Netherlands.
Robbert J de HaasDepartment of Radiology, University of Groningen, University Medical Centre Groningen, Groningen, The Netherlands.
G Matthijs KaterDepartment of Radiology, University of Groningen, University Medical Centre Groningen, Groningen, The Netherlands.
Oleksandra V IvashchenkoDepartment of Nuclear Medicine and Molecular Imaging, University of Groningen, University Medical Centre Groningen, Groningen, The Netherlands.
Walter NoordzijDepartment of Nuclear Medicine and Molecular Imaging, University of Groningen, University Medical Centre Groningen, Groningen, The Netherlands.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeYttrium-90 (

methodsThis retrospective study included 45 HCC patients with 68 lesions treated with

resultsOf 68 lesions, 44% achieved complete response. D50 did not differ significantly across mRECIST response categories. In low-D50 lesions, higher heterogeneity was associated with improved response. Hot-spot metrics (D2, D10, Dmax) showed similar trends. In high-D50 lesions, cold-spot metrics (D90, D98) were significantly associated with better response. Mean non-tumoral liver dose was associated with acute toxicity, while dose heterogeneity was associated with latent toxicity.

conclusionSpatial dose distribution influences outcomes beyond mean absorbed dose. Tumour response was related to a dose level dependent pattern, with hot-spot-driven heterogeneity associated with response at lower dose levels and cold-spot metrics more relevant at higher dose levels. In addition, a temporal dissociation in toxicity was identified, with mean non-tumoral liver dose associated with acute injury and spatial dose heterogeneity associated with latent severe toxicity, supporting further evaluation of spatial dosimetry for individualized SIRT planning.

Indexed as

Carcinoma, HepatocellularLiver NeoplasmsRadiation DosageYttrium RadioisotopesAgedDose-Response Relationship, RadiationFemaleHumansMaleMiddle AgedPositron Emission Tomography Computed TomographyRadioembolization, TherapeuticRadiotherapy DosageRetrospective StudiesTreatment Effect HeterogeneityTreatment OutcomeYttrium-90Yttrium RadioisotopesDose heterogeneityHepatocellular carcinomaSelective internal radiation therapyVoxel-based dosimetryYttrium-90

Identifiers

PMID42446581
PMCPMC13633298

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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.