327. Radioembolization with Yttrium-90 Microspheres in Hepatocellular Carcinoma: Initial Experience. (December 2018) - Severi, F.
Abstract : Purpose: We present our initial experience on transarterial radioembolization (TARE) with Yttrium-90 glass microspheres in Hepatocellular Carcinoma (HCC) patients. The first objective was to choose the procedure for defining the dose to be delivered to the patient and a first evaluation of its effectiveness. Methods: From January 2016 to October 2017, 18 consecutive patients (M = 17, F = 1, median age 73 [24–85] years) with HCC were selected. TARE was performed using 90 Y glass microspheres[1] . The administration activity was defined by the MIRD method based on the uptake volume[2] . Lung and gastrointestinal tract shunts were evaluated two weeks before the TARE, by a diagnostic angiography and, respectively, scintigraphy and SPECT/CT, after hepatic perfusion with 99m Tc macroaggregated albumin (MAA). 90 Y dose was personalized based on the 99m Tc MAA SPECT/CT dose distribution. The mean dosimetric parameters are: Lesion Volume (cm 3 ) 144, Target/Uptake Dose (Gy) 216, Target Volume (cm 3 ) 371, Liver Treated (%) 25, Lung Shunt (%) 7, Non Tumoral Liver Dose (Gy) 6, Total Activity Administered (GBq) 1.6. Response evaluation was performed in 17 patients. Results: Complete response occurred in 9 patients, partial response in 5 patients, while progression was seen in 3 patients. During a median clinical follow-up of 8 (3–18) months, 6 patients died. Median disease free survival and overall survival were respectively 13 and 16 months. One patient led to down-staging, allowing liver transplantation. Conclusions: The dose definition procedure adopted proved to be effective, in the reduced number of cases treated. More data need to be acquired to confirm this preliminary result.