Purpose

The aim of this study was to investigate the relationship between voxel-based dosimetric variables derived from Y-90 PET/MRI and hypertrophy observed in the left lobe after radioembolization and to investigate if there is any difference in hypertrophy induced by glass versus resin microspheres.

Methods

Voxel-based dosimetry-derived variables and their relationship with the change of the standardized future liver remnant (ΔFLR) was investigated with linear regression models. To compare and evaluate the discriminatory power of the dosimetric variables, ROC analyses were utilized. ΔFLR and kinetic growth rate (KGR) induced with glass and resin microspheres were compared using the Mann–Whitney U test.

Results

In this retrospective study, data of the 40 patients treated with Y-90 microspheres were evaluated. Among the several dosimetric variables, the mean perfused volume normal tissue dose (pDnorm), perfused normal tissue V90 (pV90), and pV100 values for glass microspheres; and the mean whole liver normal tissue dose (Dnorm), pDnorm, whole liver normal tissue V30 (nV30), nV40, and pV40 for resin microspheres had the highest relationship with ΔFLR. In the ROC analysis for glass microspheres, the optimal cut-offs to predict ΔFLR > 5% were 60.55 Gy for Dnorm, 94.21 Gy for pDnorm, 28.07% for pV90, and 24.98% for pV100. For resin microspheres, corresponding values were 23.20 Gy for Dnorm, 37.40 Gy for pDnorm, 31.50% for nV30, 24.50% for nV40, and 43.60% for pV40. No significant difference was observed between glass and resin microsphere-induced median ΔFLR, KGR values and atrophy of the right lobe.

Conclusion

Following Y-90 radioembolization therapy with glass and resin microspheres applied to the right lobe of the liver, ΔFLR is correlated with pDnorm and Dnorm, but is also significantly related to various nV and pV values. In addition, the hypertrophy and kinetic growth rates observed with glass and resin microspheres were largely similar.

中文翻译：

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使用 Y-90 微球放射栓塞肝脏肿瘤后，使用集成 Y-90 PET/MRI 用基于体素的剂量测定预测左叶肥大

 目的

本研究的目的是研究 Y-90 PET/MRI 得出的基于体素的剂量学变量与放射栓塞后左叶观察到的肥大之间的关系，并研究玻璃微球与树脂微球诱导的肥大是否存在任何差异。

 方法

用线性回归模型研究了基于体素的剂量学衍生变量及其与标准化未来残余肝 （ΔFLR） 变化的关系。为了比较和评估剂量学变量的判别能力，使用了 ROC 分析。使用 Mann-Whitney U 检验比较玻璃和树脂微球诱导的 ΔFLR 和动力学生长速率 （KGR）。

 结果

在这项回顾性研究中，评估了 40 例接受 Y-90 微球治疗的患者的数据。在几个剂量学变量中，玻璃微球的平均灌注体积正常组织剂量 （pDnorm） 、灌注正常组织 V90 （pV90） 和 pV100 值;树脂微球的平均全肝正常组织剂量 （Dnorm ） 、 pDnorm 、 全肝正常组织 V30 （nV30 ） 、 nV40 和 pV40 与 ΔFLR 的关系最高。在玻璃微球的 ROC 分析中，预测 ΔFLR > 5% 的最佳截断值为 Dnorm 为 60.55 Gy，pDnorm 为 94.21 Gy，pV90 为 28.07%，pV100 为 24.98%。对于树脂微球，Dnorm 的相应值为 23.20 Gy，pDnorm 为 37.40 Gy，nV30 为 31.50%，nV40 为 24.50%，pV40 为 43.60%。玻璃和树脂微球诱导的中位 ΔFLR 、 KGR 值和右叶萎缩之间未观察到显著差异。

 结论

在将玻璃和树脂微球应用于肝右叶的 Y-90 放射栓塞治疗后，ΔFLR 与 pDnorm 和 Dnorm 相关，但也与各种 nV 和 pV 值显着相关。此外，用玻璃和树脂微球观察到的肥大和动力学生长速率在很大程度上相似。