Radiographic response to yttrium-90 radioembolization in anterior versus posterior liver segments.
The purpose of our study was to determine if preferential radiographic tumor response occurs in tumors located in posterior versus anterior liver segments following radioembolization with yttrium-90 glass microspheres. One hundred thirty-seven patients with chemorefractory liver metastases of various primaries were treated with yttrium-90 glass microspheres. Of these, a subset analysis was performed on 89 patients who underwent 101 whole-right-lobe infusions to liver segments V, VI, VII, and VIII. Pre- and posttreatment imaging included either triphasic contrast material-enhanced CT or gadolinium-enhanced MRI. Responses to treatment were compared in anterior versus posterior right lobe lesions using both RECIST and WHO criteria. Statistical comparative studies were conducted in 42 patients with both anterior and posterior segment lesions using the paired-sample t-test. Pearson correlation was used to determine the relationship between pretreatment tumor size and posttreatment tumor response. Median administered activity, delivered radiation dose, and treatment volume were 2.3 GBq, 118.2 Gy, and 1,072 cm(3), respectively. Differences between the pretreatment tumor size of anterior and posterior liver segments were not statistically significant (p = 0.7981). Differences in tumor response between anterior and posterior liver segments were not statistically significant using WHO criteria (p = 0.8557). A statistically significant correlation did not exist between pretreatment tumor size and posttreatment tumor response (r = 0.0554, p = 0.4434). On imaging follow-up using WHO criteria, for anterior and posterior regions of the liver, (1) response rates were 50% (PR = 50%) and 45% (CR = 9%, PR = 36%), and (2) mean changes in tumor size were -41% and -40%. In conclusion, this study did not find evidence of preferential radiographic tumor response in posterior versus anterior liver segments treated with yttrium-90 glass microspheres.
Department of Radiology, Section of Interventional Radiology, Northwestern University, 676 N. St. Claire, Suite 800, Chicago, IL 60611, USA.
Saad M
SM
Ibrahim
Robert J
RJ
Lewandowski
Robert K
RK
Ryu
Kent T
KT
Sato
Vanessa L
VL
Gates
Mary F
MF
Mulcahy
Laura
L
Kulik
Andrew C
AC
Larson
Reed A
RA
Omary
Riad
R
Salem
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003287:Contrast Media; D005260:Female; D006801:Humans; D008113:Liver Neoplasms / Q000532:radiotherapy* / Q000556:secondary; D008279:Magnetic Resonance Imaging; D008297:Male; D008863:Microspheres; D008875:Middle Aged; D011446:Prospective Studies; D011879:Radiotherapy Dosage; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D015021:Yttrium Radioisotopes / Q000627:therapeutic use*
D003287:Contrast Media; D015021:Yttrium Radioisotopes