Biodistribution, pharmacokinetics, and organ-level dosimetry for 188Re-AHDD-Lipiodol radioembolization based on quantitative post-treatment SPECT/CT scans
Abstract Background Rhenium-188-labelled-Lipiodol radioembolization is a safe and cost-effective treatment for primary liver cancer. In order to determine correlations between treatment doses and patient response to therapy, accurate patient-specific dosimetry is required. Up to date, the reported d...
| Autores principales: | , , , , |
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| Formato: | Artículo |
| Lenguaje: | English |
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SpringerOpen
2018-12-01
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| Colección: | EJNMMI Physics |
| Materias: | |
| Acceso en línea: | http://link.springer.com/article/10.1186/s40658-018-0227-6 |
| _version_ | 1831723883838832640 |
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| author | Pedro L. Esquinas Ajit Shinto Koramadai K. Kamaleshwaran Jephy Joseph Anna Celler |
| author_facet | Pedro L. Esquinas Ajit Shinto Koramadai K. Kamaleshwaran Jephy Joseph Anna Celler |
| author_sort | Pedro L. Esquinas |
| collection | DOAJ |
| description | Abstract Background Rhenium-188-labelled-Lipiodol radioembolization is a safe and cost-effective treatment for primary liver cancer. In order to determine correlations between treatment doses and patient response to therapy, accurate patient-specific dosimetry is required. Up to date, the reported dosimetry of 188Re-Lipiodol has been based on whole-body (WB) planar imaging only, which has limited quantitative accuracy. The aim of the present study is to determine the in vivo pharmacokinetics, bio-distribution, and organ-level dosimetry of 188Re-AHDD-Lipiodol radioembolization using a combination of post-treatment planar and quantitative SPECT/CT images. Furthermore, based on the analysis of the pharmacokinetic data, a practical and relatively simple imaging and dosimetry method that could be implemented in clinics for 188Re-AHDD-Lipiodol radioembolization is proposed. Thirteen patients with histologically proven hepatocellular carcinoma underwent 188Re-AHDD-Lipiodol radioembolization. A series of 2–3 WB planar images and one SPECT/CT scan were acquired over 48 h after the treatment. The time-integrated activity coefficients (TIACs, also known as residence-times) and absorbed doses of tumors and organs at risk (OARs) were determined using a hybrid WB/SPECT imaging method. Results Whole-body imaging showed that 188Re-AHDD-Lipiodol accumulated mostly in the tumor and liver tissue but a non-negligible amount of the pharmaceutical was also observed in the stomach, lungs, salivary glands, spleen, kidneys, and urinary bladder. On average, the measured effective half-life of 188Re-AHDD-Lipiodol was 12.5 ± 1.9 h in tumor. The effective half-life in the liver and lungs (the two organs at risk) was 12.6 ± 1.7 h and 12.0 ± 1.9 h, respectively. The presence of 188Re in other organs was probably due to the chemical separation and subsequent release of the free radionuclide from Lipiodol. The average doses per injected activity in the tumor, liver, and lungs were 23.5 ± 40.8 mGy/MBq, 2.12 ± 1.78 mGy/MBq, and 0.11 ± 0.05 mGy/MBq, respectively. The proposed imaging and dosimetry method, consisting of a single SPECT/CT for activity determination followed by 188Re-AHDD-Lipiodol clearance with the liver effective half-life of 12.6 h, resulted in TIACs estimates (and hence, doses) mostly within ± 20% from the reference TIACs (estimated using three WB images and one SPECT/CT). Conclusions The large inter-patient variability of the absorbed doses in tumors and normal tissue in 188Re-HDD-Lipiodol radioembolization patients emphasizes the importance of patient-specific dosimetry calculations based on quantitative post-treatment SPECT/CT imaging. |
| first_indexed | 2024-12-21T04:11:11Z |
| format | Article |
| id | doaj.art-f94e63440fad4208b55b8b2a105fd1c6 |
| institution | Directory Open Access Journal |
| issn | 2197-7364 |
| language | English |
| last_indexed | 2024-12-21T04:11:11Z |
| publishDate | 2018-12-01 |
| publisher | SpringerOpen |
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| series | EJNMMI Physics |
| spelling | doaj.art-f94e63440fad4208b55b8b2a105fd1c62022-12-21T19:16:27ZengSpringerOpenEJNMMI Physics2197-73642018-12-015112210.1186/s40658-018-0227-6Biodistribution, pharmacokinetics, and organ-level dosimetry for 188Re-AHDD-Lipiodol radioembolization based on quantitative post-treatment SPECT/CT scansPedro L. Esquinas0Ajit Shinto1Koramadai K. Kamaleshwaran2Jephy Joseph3Anna Celler4Department of Radiology, University of British ColumbiaDepartment of Nuclear Medicine, Kovai Medical Center and HospitalDepartment of Nuclear Medicine, Kovai Medical Center and HospitalDepartment of Nuclear Medicine, Kovai Medical Center and HospitalDepartment of Radiology, University of British ColumbiaAbstract Background Rhenium-188-labelled-Lipiodol radioembolization is a safe and cost-effective treatment for primary liver cancer. In order to determine correlations between treatment doses and patient response to therapy, accurate patient-specific dosimetry is required. Up to date, the reported dosimetry of 188Re-Lipiodol has been based on whole-body (WB) planar imaging only, which has limited quantitative accuracy. The aim of the present study is to determine the in vivo pharmacokinetics, bio-distribution, and organ-level dosimetry of 188Re-AHDD-Lipiodol radioembolization using a combination of post-treatment planar and quantitative SPECT/CT images. Furthermore, based on the analysis of the pharmacokinetic data, a practical and relatively simple imaging and dosimetry method that could be implemented in clinics for 188Re-AHDD-Lipiodol radioembolization is proposed. Thirteen patients with histologically proven hepatocellular carcinoma underwent 188Re-AHDD-Lipiodol radioembolization. A series of 2–3 WB planar images and one SPECT/CT scan were acquired over 48 h after the treatment. The time-integrated activity coefficients (TIACs, also known as residence-times) and absorbed doses of tumors and organs at risk (OARs) were determined using a hybrid WB/SPECT imaging method. Results Whole-body imaging showed that 188Re-AHDD-Lipiodol accumulated mostly in the tumor and liver tissue but a non-negligible amount of the pharmaceutical was also observed in the stomach, lungs, salivary glands, spleen, kidneys, and urinary bladder. On average, the measured effective half-life of 188Re-AHDD-Lipiodol was 12.5 ± 1.9 h in tumor. The effective half-life in the liver and lungs (the two organs at risk) was 12.6 ± 1.7 h and 12.0 ± 1.9 h, respectively. The presence of 188Re in other organs was probably due to the chemical separation and subsequent release of the free radionuclide from Lipiodol. The average doses per injected activity in the tumor, liver, and lungs were 23.5 ± 40.8 mGy/MBq, 2.12 ± 1.78 mGy/MBq, and 0.11 ± 0.05 mGy/MBq, respectively. The proposed imaging and dosimetry method, consisting of a single SPECT/CT for activity determination followed by 188Re-AHDD-Lipiodol clearance with the liver effective half-life of 12.6 h, resulted in TIACs estimates (and hence, doses) mostly within ± 20% from the reference TIACs (estimated using three WB images and one SPECT/CT). Conclusions The large inter-patient variability of the absorbed doses in tumors and normal tissue in 188Re-HDD-Lipiodol radioembolization patients emphasizes the importance of patient-specific dosimetry calculations based on quantitative post-treatment SPECT/CT imaging.http://link.springer.com/article/10.1186/s40658-018-0227-6Rhenium-188AHDD-LipiodolQuantitative SPECTRadioembolizationDosimetryHepatocellular carcinoma |
| spellingShingle | Pedro L. Esquinas Ajit Shinto Koramadai K. Kamaleshwaran Jephy Joseph Anna Celler Biodistribution, pharmacokinetics, and organ-level dosimetry for 188Re-AHDD-Lipiodol radioembolization based on quantitative post-treatment SPECT/CT scans EJNMMI Physics Rhenium-188 AHDD-Lipiodol Quantitative SPECT Radioembolization Dosimetry Hepatocellular carcinoma |
| title | Biodistribution, pharmacokinetics, and organ-level dosimetry for 188Re-AHDD-Lipiodol radioembolization based on quantitative post-treatment SPECT/CT scans |
| title_full | Biodistribution, pharmacokinetics, and organ-level dosimetry for 188Re-AHDD-Lipiodol radioembolization based on quantitative post-treatment SPECT/CT scans |
| title_fullStr | Biodistribution, pharmacokinetics, and organ-level dosimetry for 188Re-AHDD-Lipiodol radioembolization based on quantitative post-treatment SPECT/CT scans |
| title_full_unstemmed | Biodistribution, pharmacokinetics, and organ-level dosimetry for 188Re-AHDD-Lipiodol radioembolization based on quantitative post-treatment SPECT/CT scans |
| title_short | Biodistribution, pharmacokinetics, and organ-level dosimetry for 188Re-AHDD-Lipiodol radioembolization based on quantitative post-treatment SPECT/CT scans |
| title_sort | biodistribution pharmacokinetics and organ level dosimetry for 188re ahdd lipiodol radioembolization based on quantitative post treatment spect ct scans |
| topic | Rhenium-188 AHDD-Lipiodol Quantitative SPECT Radioembolization Dosimetry Hepatocellular carcinoma |
| url | http://link.springer.com/article/10.1186/s40658-018-0227-6 |
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