Prospective Study of Systemic Yttrium-90 Elution during Radioembolization of Hepatic Metastases.

Autor:	Alexander ES; Department of Radiology, Hospital of the University of Pennsylvania, 3400 Spruce St., 1 Founders, MRI Education Center, Philadelphia, PA 19104. Electronic address: erica.s.alexander@gmail.com., Pantel AR; Department of Radiology, Hospital of the University of Pennsylvania, 3400 Spruce St., 1 Founders, MRI Education Center, Philadelphia, PA 19104., Carlin SD; Department of Radiology, Hospital of the University of Pennsylvania, 3400 Spruce St., 1 Founders, MRI Education Center, Philadelphia, PA 19104., Beckmann N; Environmental Health and Radiation Safety, University of Pennsylvania, Philadelphia, Pennsylvania., Mick R; Department of Biostatistics, Epidemiology and Informatics, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania., Pryma DA; Department of Radiology, Hospital of the University of Pennsylvania, 3400 Spruce St., 1 Founders, MRI Education Center, Philadelphia, PA 19104., Soulen MC; Department of Radiology, Hospital of the University of Pennsylvania, 3400 Spruce St., 1 Founders, MRI Education Center, Philadelphia, PA 19104.
Jazyk:	angličtina
Zdroj:	Journal of vascular and interventional radiology : JVIR [J Vasc Interv Radiol] 2020 Dec; Vol. 31 (12), pp. 2007-2013.e1. Date of Electronic Publication: 2020 Nov 02.
DOI:	10.1016/j.jvir.2020.08.011
Abstrakt:	Purpose: To evaluate total blood radioactivity (BR) after SIR-Spheres yttrium-90 ( 90 Y) radioembolization and differences in BR based on delivery method. Materials and Methods: Twenty participants with hepatic metastases undergoing first radioembolization were prospectively enrolled from December 2017 to June 2018. Blood samples were drawn at baseline and 0, 10, 20, 60, and 120 minutes after 90 Y administration. BR was measured with a γ-counter and scaled by estimated blood volume. Percentage of instilled radioactivity in the bloodstream was calculated as area under the fitted curve, and differences between delivery methods were examined with nonparametric statistical tests. Results: In 10 participants, resin microspheres were instilled with 50% Isovue 300 diluted in saline solution in the D line, and 10 others were treated with dextrose 5% in water (D5W) in the D line. Median administered activities were 944 MBq (range, 746-1,993 MBq) and 1,213 MBq (range, 519-2,066 MBq), respectively. Fraction of 90 Y in blood was significantly higher with dilute contrast agent than with D5W (median, 0.5% of injected activity vs 0.2%; P = .001). Among all participants, the maximum activity delivered was 2,066 MBq, and a maximum of 1% of administered radioactivity was measured as free 90 Y in blood. Assuming these highest-case values and complete decay of all free 90 Y in bone, a dose to red marrow of 132.3 mGy was calculated by Organ Level INternal Dose Assessment/EXponential Modeling. Conclusions: Blood sampling after radioembolization allowed for estimation of the time-activity curve and BR. Delivery with 50% contrast agent in saline solution resulted in a significant increase in BR vs D5W, even though the total BR for both groups was nominal. (Copyright © 2020 SIR. Published by Elsevier Inc. All rights reserved.)
Databáze:	MEDLINE
Externí odkaz:	Zobrazit plný text záznamu