Hepatobiliary scintigraphy and liver function changes in patients with hepatocellular carcinoma treated with 166Ho-radioembolization
Abstract Background To study the feasibility of hepatobiliary scintigraphy (HBS) to improve selection and planning of patients with hepatocellular carcinoma (HCC) treated with holmium-166 (166Ho)-microspheres radioembolization. Results Thirty-one patients with HCC were included and treated with 166H...
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2025-01-01
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author | Margot T.M. Reinders Maarten J.L. Smits Karel van Erpecum Joep de Bruijne Rutger C.G. Bruijnen Dave Sprengers Rob de Man Erik Vegt Jan N.M. IJzermans Marnix G.E.H. Lam Arthur J.A.T. Braat |
author_facet | Margot T.M. Reinders Maarten J.L. Smits Karel van Erpecum Joep de Bruijne Rutger C.G. Bruijnen Dave Sprengers Rob de Man Erik Vegt Jan N.M. IJzermans Marnix G.E.H. Lam Arthur J.A.T. Braat |
author_sort | Margot T.M. Reinders |
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description | Abstract Background To study the feasibility of hepatobiliary scintigraphy (HBS) to improve selection and planning of patients with hepatocellular carcinoma (HCC) treated with holmium-166 (166Ho)-microspheres radioembolization. Results Thirty-one patients with HCC were included and treated with 166Ho- radioembolization as part of a prospective phase 2 study. Twenty-seven patients were eligible for analysis, 67% had a cirrhotic liver morphology on imaging, 70% had multifocal disease and 51% had bilobar disease. None of the patients had clinical signs of liver decompensation (Child Pugh ≤ B7, median MELD 9 or ALBI − 2.55). Global and regional hepatic function was based on manual delineation of HBS using 200 MBq 99mTc-mebrofenine, acquired during screening and approximately three months after 166Ho-radioembolization, referred to as liver clearance rate (LCR). In line with LCR at baseline, a significant correlation was found between LCR and lab results, including bilirubin, albumin, ALT, MELD-score, and ALBI-score (p < 0.05) during follow-up. HBS showed a significant decrease in median LCR (-16%; p = 0.0017) and volume (-17%; p = 0.0027) in the treated liver, without a significant increase in the non-treated liver. Median relative change in overall LCR in non-cirrhotics was 0% (range − 23–33%), in cirrhotics − 10% (range − 40 − 19%; p = 0.40). Conclusion HBS showed that hepatic function and volume significantly decreased in parts of the liver treated with 166Ho-microspheres radioembolization in patients with HCC. Cirrhotic patients do not seem to have the capacity to increase hepatic function in the treated part of the liver. Trial registration Registry name: Clinicaltrials.gov. Trial number: NCT03379844. Date of registration: 21 November 2017. Trial URL: https://clinicaltrials.gov/study/NCT03379844?cond=hcc&term=hepar primary&rank=1#study-overview . |
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spelling | doaj-art-2ddf4f51a48f469dbeaf8489d218ce282025-01-12T12:39:25ZengSpringerOpenEJNMMI Research2191-219X2025-01-0115111010.1186/s13550-025-01196-9Hepatobiliary scintigraphy and liver function changes in patients with hepatocellular carcinoma treated with 166Ho-radioembolizationMargot T.M. Reinders0Maarten J.L. Smits1Karel van Erpecum2Joep de Bruijne3Rutger C.G. Bruijnen4Dave Sprengers5Rob de Man6Erik Vegt7Jan N.M. IJzermans8Marnix G.E.H. Lam9Arthur J.A.T. Braat10Department of Radiology & Nuclear Medicine, University Medical Center UtrechtDepartment of Radiology & Nuclear Medicine, University Medical Center UtrechtDepartment of Gastroenterology & Hepatology, Utrecht University - University Medical Center UtrechtDepartment of Gastroenterology & Hepatology, Utrecht University - University Medical Center UtrechtDepartment of Radiology & Nuclear Medicine, University Medical Center UtrechtDepartment of Gastroenterology & Hepatology, Erasmus MC-University Medical CentreDepartment of Gastroenterology & Hepatology, Erasmus MC-University Medical CentreDepartment of Radiology & Nuclear Medicine, Erasmus MC-University Medical CentreDepartment of Surgery, Erasmus MC-University Medical CentreDepartment of Radiology & Nuclear Medicine, University Medical Center UtrechtDepartment of Radiology & Nuclear Medicine, University Medical Center UtrechtAbstract Background To study the feasibility of hepatobiliary scintigraphy (HBS) to improve selection and planning of patients with hepatocellular carcinoma (HCC) treated with holmium-166 (166Ho)-microspheres radioembolization. Results Thirty-one patients with HCC were included and treated with 166Ho- radioembolization as part of a prospective phase 2 study. Twenty-seven patients were eligible for analysis, 67% had a cirrhotic liver morphology on imaging, 70% had multifocal disease and 51% had bilobar disease. None of the patients had clinical signs of liver decompensation (Child Pugh ≤ B7, median MELD 9 or ALBI − 2.55). Global and regional hepatic function was based on manual delineation of HBS using 200 MBq 99mTc-mebrofenine, acquired during screening and approximately three months after 166Ho-radioembolization, referred to as liver clearance rate (LCR). In line with LCR at baseline, a significant correlation was found between LCR and lab results, including bilirubin, albumin, ALT, MELD-score, and ALBI-score (p < 0.05) during follow-up. HBS showed a significant decrease in median LCR (-16%; p = 0.0017) and volume (-17%; p = 0.0027) in the treated liver, without a significant increase in the non-treated liver. Median relative change in overall LCR in non-cirrhotics was 0% (range − 23–33%), in cirrhotics − 10% (range − 40 − 19%; p = 0.40). Conclusion HBS showed that hepatic function and volume significantly decreased in parts of the liver treated with 166Ho-microspheres radioembolization in patients with HCC. Cirrhotic patients do not seem to have the capacity to increase hepatic function in the treated part of the liver. Trial registration Registry name: Clinicaltrials.gov. Trial number: NCT03379844. Date of registration: 21 November 2017. Trial URL: https://clinicaltrials.gov/study/NCT03379844?cond=hcc&term=hepar primary&rank=1#study-overview .https://doi.org/10.1186/s13550-025-01196-9Hepatobiliary scintigraphyHolmiumRadioembolizationHepatocellular carcinomaHepatic functionLiver clearance rate |
spellingShingle | Margot T.M. Reinders Maarten J.L. Smits Karel van Erpecum Joep de Bruijne Rutger C.G. Bruijnen Dave Sprengers Rob de Man Erik Vegt Jan N.M. IJzermans Marnix G.E.H. Lam Arthur J.A.T. Braat Hepatobiliary scintigraphy and liver function changes in patients with hepatocellular carcinoma treated with 166Ho-radioembolization EJNMMI Research Hepatobiliary scintigraphy Holmium Radioembolization Hepatocellular carcinoma Hepatic function Liver clearance rate |
title | Hepatobiliary scintigraphy and liver function changes in patients with hepatocellular carcinoma treated with 166Ho-radioembolization |
title_full | Hepatobiliary scintigraphy and liver function changes in patients with hepatocellular carcinoma treated with 166Ho-radioembolization |
title_fullStr | Hepatobiliary scintigraphy and liver function changes in patients with hepatocellular carcinoma treated with 166Ho-radioembolization |
title_full_unstemmed | Hepatobiliary scintigraphy and liver function changes in patients with hepatocellular carcinoma treated with 166Ho-radioembolization |
title_short | Hepatobiliary scintigraphy and liver function changes in patients with hepatocellular carcinoma treated with 166Ho-radioembolization |
title_sort | hepatobiliary scintigraphy and liver function changes in patients with hepatocellular carcinoma treated with 166ho radioembolization |
topic | Hepatobiliary scintigraphy Holmium Radioembolization Hepatocellular carcinoma Hepatic function Liver clearance rate |
url | https://doi.org/10.1186/s13550-025-01196-9 |
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