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The Radiation Dose Absorbed by Healthy Parenchyma Is a Predictor for the Rate of Contralateral Hypertrophy After Unilobar Radioembolization of the Right Liver

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Abstract

Purpose

To investigate the predictors of contralateral hypertrophy in patients treated with unilobar transarterial radioembolization (TARE) with yttrium-90-loaded resin microspheres due to unresectable right-liver tumors.

Methods

Patients who underwent right unilobar TARE with resin microspheres between May 2019 and September 2021 were screened retrospectively. Contralateral hypertrophy was evaluated by calculating the kinetic growth rate (KGR) in 8–10 weeks after TARE. The predictors of increased KGR were determined with linear regression analysis.

Results

A total of 24 patients (16 with primary and 8 with metastatic liver tumors) were included in the study. After right unilobar TARE, mean volume of the left lobe increased from 368.26 to 436.16 mL, while the mean volume of the right lobe decreased from 1576.22 to 1477.89 mL. The median KGR of the left lobe was 0.28% per week. The radiation dose absorbed by the healthy parenchyma of the right lobe was significantly higher in patients with increased KGR (31.62 vs. 18.78 Gy, p = 0.037). Linear regression analysis showed that the dose absorbed by healthy parenchyma was significantly associated with increased KGR (b = 0.014, p = 0.043).

Conclusion

Patients who received right unilobar TARE for liver malignancies could develop a substantial contralateral hypertrophy, and the radiation dose absorbed by the healthy parenchyma of the right lobe was significantly associated with increased KGR in the left lobe. TARE could have a role for inducing contralateral hypertrophy as it offers the advantage of concurrent local tumor control along with its hypertrophic effect.

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Acknowledgements

We thank all staffs in the departments of Nuclear Medicine and Interventional Radiology for their hard work in radioembolization procedures.

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Authors and Affiliations

  1. Department of Nuclear Medicine, Ankara City Hospital, Ankara, Turkey

    Nazim Coskun, Aslihan Yildirim, Alptug Ozer Yuksel & Elif Ozdemir

  2. Department of Radiology, Ankara Yildirim Beyazit University, Ankara, Turkey

    Murat Canyigit

  3. Department of Nuclear Medicine, Ankara Yildirim Beyazit University, Ankara, Turkey

    Elif Ozdemir

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  1. Nazim Coskun
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Contributions

All authors contributed to the study conception and design. Material preparation and data collection were performed by Aslihan Yildirim, Nazim Coskun, and Alptug Ozer Yuksel. The first draft of the manuscript was written by Nazim Coskun and all authors commented on the previous versions of the manuscript. The study was supervised by Elif Ozdemir and Murat Canyigit. All authors read and approved the final manuscript.

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Correspondence to Nazim Coskun.

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Ethics Approval and Consent to Participate

The study was approved by the institutional review board of Ankara City Hospital (approval no: E2-22-1684), and informed consent was obtained from all individual participants included in the study (or the requirement for written consent was waived by the institutional review board). All procedures performed in studies involving human participants were in accordance with the Helsinki Declaration as revised in 2013 and its later amendments.

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The participants signed consent regarding publishing their data (and/or photographs).

Competing Interests

Nazim Coskun, Aslihan Yildirim, Alptug Ozer Yuksel, Murat Canyigit, and Elif Ozdemir declare that they have no competing interests.

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Coskun, N., Yildirim, A., Yuksel, A.O. et al. The Radiation Dose Absorbed by Healthy Parenchyma Is a Predictor for the Rate of Contralateral Hypertrophy After Unilobar Radioembolization of the Right Liver. Nucl Med Mol Imaging 56, 291–298 (2022). https://doi.org/10.1007/s13139-022-00770-6

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  • DOI: https://doi.org/10.1007/s13139-022-00770-6

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