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Prior ablation and progression of disease correlate with higher tumor-to-normal liver 99mTc-MAA uptake ratio in hepatocellular carcinoma

  • Interventional Radiology
  • Published:
Abdominal Radiology Aims and scope Submit manuscript

Abstract

Purpose

Factors affecting tumor-to-normal tissue ratio (T:N) have implications for patient selection, dosimetry, and outcomes when considering radioembolization for HCC. This study sought to evaluate patient, disease specific, and technical parameters that predict T:N as measured on planning pre-90Y radioembolization 99mTc-MAA scintigraphy for hepatocellular carcinoma (HCC).

Methods

99mTc-MAA hepatic angiography procedures with SPECT/CT over a 4-year period were reviewed. Data recorded included patient demographics, details of underlying liver disease, tumor size, history of prior treatments for HCC and technical parameters from angiography. Anatomic-based segmentation was performed in 93 cases for measurement of tumor and perfused liver volumes and SPECT counts. T:N were calculated and correlated with collected variables.

Results

Mean calculated T:N was 2.52. History of prior ablation was significantly correlated with higher T:N (mean 3.39 vs 2.24, p = 0.003). Cases in which mapping was being performed for treatment of disease progression was significantly correlated with higher T:N (mean 3.35 vs 2.14, p = 0.001). Larger tumor size trended toward lower T:N (p = 0.052).

Conclusion

Patients with history of ablation and those undergoing treatment for disease progression have higher T:N and, therefore, could be considered for radioembolization preferentially over alternative treatments.

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Acknowledgements

The authors would like to acknowledge Mirada Medical (Denver, CO) for providing access to and support for their Simplicit90Y image fusion and dosimetry planning software.

Funding

Mikin V Patel has received consulting fees and speaker honoraria from Boston Scientific. This study was self-funded. No external funding sources were used.

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Authors and Affiliations

  1. Department of Radiology, University of Chicago Medical Center, 5841 S Maryland Ave, MC 2026, Chicago, IL, 60637, USA

    Mikin V. Patel

  2. Department of Medical Imaging, University of Arizona Medical Center, Tucson, AZ, USA

    David McNiel, Christopher Brunson, Phillip H. Kuo, Charles T. Hennemeyer & Gregory Woodhead

  3. Department of Radiology, University of Washington Medicine, Seattle, WA, USA

    Hugh McGregor

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  1. Mikin V. Patel
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  2. David McNiel
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Correspondence to Mikin V. Patel.

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Patel, M.V., McNiel, D., Brunson, C. et al. Prior ablation and progression of disease correlate with higher tumor-to-normal liver 99mTc-MAA uptake ratio in hepatocellular carcinoma. Abdom Radiol 48, 752–757 (2023). https://doi.org/10.1007/s00261-022-03718-8

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  • DOI: https://doi.org/10.1007/s00261-022-03718-8

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