Prospective Study of Systemic Yttrium-90 Elution during Radioembolization of Hepatic Metastases |
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| Affiliation: | 1. Department of Radiology, Hospital of the University of Pennsylvania, 3400 Spruce St., 1 Founders, MRI Education Center, Philadelphia, PA 19104;2. Environmental Health and Radiation Safety, University of Pennsylvania, Philadelphia, Pennsylvania;3. Department of Biostatistics, Epidemiology and Informatics, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania;1. Department of Radiology and Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea;2. Department of Clinical Epidemiology and Biostatistics, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea;1. Department of General Surgery, Saint Joseph Hospital, 1375 E. 19th Ave., Denver, CO 80218;2. Department of Vascular Therapy and Interventional Radiology, Colorado Permanente Medical Group, 2045 Franklin St., Denver, CO 80205;1. Department of Interventional Radiology, Pisa University Hospital, via Paradisa 2, 56100 Pisa, Italy;2. Department of Nuclear Medicine, Pisa University Hospital, via Paradisa 2, 56100 Pisa, Italy;3. Department of Health Physics, Pisa University Hospital, via Paradisa 2, 56100 Pisa, Italy;1. Neurointerventional and Interventional Vascular Unit, Hôpital Pasteur 2, University of Nice, 30 voie Romaine, Nice 06000, France;2. Service de Réanimation, Hôpital Pasteur 2, University of Nice, 30 voie Romaine, Nice 06000, France;3. Service de Radiologie, Hôpital Pasteur 2, University of Nice, 30 voie Romaine, Nice 06000, France |
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| Abstract: | PurposeTo evaluate total blood radioactivity (BR) after SIR-Spheres yttrium-90 (90Y) radioembolization and differences in BR based on delivery method.Materials and MethodsTwenty 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 90Y 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.ResultsIn 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 90Y 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 90Y in blood. Assuming these highest-case values and complete decay of all free 90Y in bone, a dose to red marrow of 132.3 mGy was calculated by Organ Level INternal Dose Assessment/EXponential Modeling.ConclusionsBlood 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. |
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