title: Evaluation of the response to selective internal radiation therapy in patients with hepatocellular cancer according to pretreatment (99m)Tc-MAA uptake.
abstract: OBJECTIVE
  The aim of the study was to evaluate if there is a prognostic importance of pretreatment Tc-MAA uptake of liver lesion of patients who received Y selective internal radiation therapy (SIRT) treatment for hepatocellular cancer (HCC) or not.
  
  
  METHODS
  Nineteen patients (5 female and 14 male patients; mean age, 64.5 ± 14.7 years; range, 57-73 years) who received SIRT treatment in our department for HCC between June 2008 and May 2011 were included in the study. All the patients have undergone Tc-MAA scintigraphy within 2 weeks' period before treatment for evaluation of presence of extrahepatic uptake. Patients were evaluated according to their lesions' Tc-MAA uptake patterns. Response to the treatment, presence of progression after treatment, and progression-free survival of all the patients were calculated.
  
  
  RESULTS
  Treatment has been administered on the right and left lobes of the liver in 18 and 1 patient, respectively. The mean treatment dose was estimated as 1.4 + 1.0 GBq. In the pretreatment Tc-MAA scintigraphy, liver lesions of 5 patients were hypoactive, and 14 patients were hyperactive. In the hypoactive group, whereas 2 patients (40%) were responders to treatment, 3 were nonresponders (60%). In the hyperactive group, 8 (58%) and 6 (42%) patients were responders and nonresponders, respectively (P = 0.51). Disease progression was seen in 4 (80%) and 8 patients (58%) in the hypoactive group and hyperactive groups, respectively (P = 0.36). Progression-free survival of the hypoactive group was calculated as 8 ± 4.3 months and of the hyperactive group 11 ± 4.7 months (P = 0.22).
  
  
  CONCLUSIONS
  Despite the small number of patients, this study revealed that there is no significance between tumor response and progression rates of patients who received SIRT for HCC with or without pretreatment Tc-MAA uptake in liver lesions. Selective internal radiation therapy could be safely performed in patients who have hypoactive lesions in Tc-MAA scintigraphy.
authors: Department of Nuclear Medicine, Ankara University Medical School, Ankara, Turkey.
authors: Ozlem N
authors: ON
authors: Kucuk
authors: Cigdem
authors: C
authors: Soydal
authors: Mine
authors: M
authors: Araz
authors: Elgin
authors: E
authors: Ozkan
authors: Gulseren
authors: G
authors: Aras
mesh_terms: D000368:Aged; D018450:Disease Progression; D005260:Female; D006801:Humans; D008113:Liver Neoplasms / Q000000981:diagnostic imaging* / Q000532:radiotherapy*; D008297:Male; D008875:Middle Aged; D011877:Radionuclide Imaging; D016019:Survival Analysis; D013668:Technetium Tc 99m Aggregated Albumin / Q000493:pharmacokinetics*; D016896:Treatment Outcome
chemical_list: D013668:Technetium Tc 99m Aggregated Albumin