albumin - publications

Predict more albumin - ligand interactions now!

1. J Nucl Med. 2012 Feb;53(2):255-63.

Dosimetry Based on 99mTc-Macroaggregated Albumin SPECT/CT Accurately Predicts
Tumor Response and Survival in Hepatocellular Carcinoma Patients Treated with
90Y-Loaded Glass Microspheres: Preliminary Results.

Garin E, Lenoir L, Rolland Y, Edeline J, Mesbah H, Laffont S, Porée P, Clément B,
Raoul JL, Boucher E.

Department of Nuclear Medicine, Comprehensive Cancer Institute Eugène Marquis, CS
44229, F-35042 Rennes, France.

Radioembolization of liver cancers using (90)Y-loaded microspheres is
experiencing more widespread use. However, few data are available concerning the
doses delivered to the tumors and the healthy liver. This retrospective study was
conducted to calculate the tumor dosimetry (planned tumor dose [T(plan) D]) and
nontumor dosimetry in patients treated by (90)Y-loaded glass microspheres and
determine whether tumor dosimetry could predict response and survival.METHODS:
Thirty-six patients with hepatocellular carcinoma (HCC), including 16 with portal
vein thrombosis (PVT), were treated with (90)Y-loaded glass microspheres. The
T(plan) D and the dose delivered to the injected healthy liver were calculated
using a quantitative analysis of the (99m)Tc-macroaggregated albumin
((99m)Tc-MAA) SPECT/CT exam. Responses were assessed after 3 mo, using the
criteria of the European Association for the Study of the Liver. Progression-free
survival (PFS) and overall survival (OS) were evaluated using Kaplan-Meier tests.
RESULTS: The response rate was 69% for the overall population and 75% for the PVT
patients. The dose delivered to the tumor was the only parameter associated with
response with multivariate analysis (P = 0.019). A threshold T(plan) D value of
205 Gy was predictive of response, with a sensitivity of 100% and an accuracy of
91%. Quantitative (99m)Tc-MAA SPECT/CT allowed us to increase the injected
activity for 4 patients with large lesions. PFS was only 5.2 mo and OS 9 mo when
using a T(plan) D of less than 205 Gy versus 14 mo (P = 0.0003) and 18 mo (P =
0.0322), respectively, with a T(plan) D of 205 Gy or more.
CONCLUSION: Quantitative (99m)Tc-MAA SPECT/CT is predictive of response, PFS, and
OS. Dosimetry based on (99m)Tc-MAA SPECT/CT can be used for the selection of
patients and for an adaptation of treatment planning, especially in selected
patients (particularly in the case of large tumors). These results also confirm
the efficacy and safety of (90)Y-loaded microspheres in treating HCC, even in the
presence of PVT (and especially when (99m)Tc-MAA uptake is seen inside the PVT).

PMID: 22302962 [PubMed - in process]