PET-CT evaluation of the effectiveness of selective internal radiation therapy with 90Y resin microspheres on liver-lung shunt fraction in patients with hepatic malignant tumors
PET-CT evaluation of the effectiveness of selective internal radiation therapy with 90Y resin microspheres on liver-lung shunt fraction in patients with hepatic malignant tumors
Objective To study the variation of pulmonary radioactivity and its pattern in patients with hepatic malignant tumors undergoing 90Y resin microspheres selective internal radiation therapy(SIRT),aiming to enhance the safety of clinical treatment.Methods Eight patients with hepatic malignant tumors who underwent 90Y SIRT were retrospectively analyzed,and immediate PET-CT scan images were obtained.Preoperatively,patients underwent 99mTc-MAA pulmonary perfusion imaging evaluation,with results indicating a pulmonary shunting fraction＜20%,meeting the international treatment eligibility criteria.Maximum standard uptake values(SUVmax)of hepatic tumors and both lungs were measured on PET-CT scans,and the lung-to-liver(L/T)SUVmax ratio(L/T SUVmax)was calculated.Correlation analysis was performed to assess the relationship between L/T SUVmax and injected radioactivity of 90Y resin microspheres.Patients were followed up at 3 months to evaluate treatment efficacy and pulmonary radiation injury.Results All 8 patients receiving 90Y SIRT had L/T SUVmax＜15%,showing a significant positive correlation between L/T SUVmax and the injected radioactivity of 90Y resin microspheres(r=0.854,P＜0.01).Conclusion The lung shunting fraction in 90Y SIRT for hepatic malignant tumors is significantly lower than the international standard,and it correlates positively with the dosage of injected 90Y resin microspheres.
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