RESUMEN
INTRODUCTION: There are two different types of 90Y Microspheres, glass and resin, in the market for 90Y radioembolization (90Y-RE). This study aimed to investigate the dose of radiation delivered through glass vs. resin-based 90Y-RE to intrahepatic cholangiocarcinoma (ICC). METHODS: In this retrospective study, 10 patients with ICC underwent 90Y-RE, five underwent glass (Glass group) and other 5 resin (Resin group) microspheres. Technetium-99m macro-aggregated albumin (Tc-99m MAA) shunt study was performed two weeks before 90Y-RE. Within 2â¯h from 90Y-RE, Bremsstrahlung SPECT/CT was obtained. Regions of interest (ROIs) were segmented around the targeted tumor and the liver. Tumor and liver volumes, corresponding radioactive counts, and tumor to liver count ratio were calculated using MIM software and compared between Glass and Resin groups. RESULTS: Mean hepatopulmonary shunt fraction was 7.1 vs. 6.2% for the Glass and Resin groups (pâ¯=â¯0.83), with no extrahepatic activity. There was no difference in the activity and tumor uptake of administered Tc-99m MAA between both groups (pâ¯=â¯0.71 and pâ¯=â¯0.63). Mean administered activity of 90Y in the Glass group was higher than the Resin group (73.2⯱â¯24.3 vs. 44.5⯱â¯18.2â¯mCi, pâ¯<â¯0.001). The tumor 90Y uptake was significantly higher in the Glass group compared to the Resin group (41.3% vs. 33.5%, pâ¯<â¯0.001), corresponding to the mean tumor dose of 205.7⯱â¯19.7 vs. 128.9⯱â¯10.6â¯Gy, respectively (pâ¯<â¯0.001). The tumor to normal liver parenchyma 90Y dose ratio was significantly higher in the Glass group compared to the Resin group, 4.9⯱â¯0.7 versus 2.4⯱â¯0.3 respectably (pâ¯<â¯0.001). CONCLUSIONS: Both 90Y glass and resin-based microsphere 90Y-RE are feasible and safe in patients with ICC, while 90Y glass microsphere delivers higher dose of 90Y to the targeted tumors. ADVANCES IN KNOWLEDGE: While both 90Y glass and resin-based microsphere yttrium-90 radioembolization are feasible and safe treatment options for in patients with intrahepatic cholangiocarcinoma, 90Y glass microsphere delivers higher dose of 90Y to the targeted tumors. IMPLICATIONS FOR PATIENT CARE: Both of 90Y glass and resin-based microsphere can be safely and feasibly used for treatment of intrahepatic cholangiocarcinoma, difference in dose of 90Y delivered to the targeted tumors should be clinically considered while choosing the microsphere type.
Asunto(s)
Neoplasias de los Conductos Biliares/radioterapia , Colangiocarcinoma/radioterapia , Embolización Terapéutica , Vidrio/química , Microesferas , Resinas Sintéticas/química , Radioisótopos de Itrio/uso terapéutico , Neoplasias de los Conductos Biliares/diagnóstico por imagen , Neoplasias de los Conductos Biliares/metabolismo , Transporte Biológico , Colangiocarcinoma/diagnóstico por imagen , Colangiocarcinoma/metabolismo , Femenino , Humanos , Masculino , Persona de Mediana Edad , Radiometría , Estudios Retrospectivos , Tomografía Computarizada por Tomografía Computarizada de Emisión de Fotón Único , Agregado de Albúmina Marcado con Tecnecio Tc 99m/química , Agregado de Albúmina Marcado con Tecnecio Tc 99m/metabolismo , Agregado de Albúmina Marcado con Tecnecio Tc 99m/uso terapéuticoRESUMEN
A 15-year-old girl was referred to a dentist complaining of parageusia, bad taste in the mouth, which started 9 months ago. Panoramic X-ray and non-enhanced computed tomography scan revealed multiple bilateral unilocular cysts in the mandible and maxilla, along with calcification of anterior part of the falx cerebri. She was eventually diagnosed with Gorlin-Goltz syndrome based on imaging and histopathologic finding of keratocystic odontogenic tumor.