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Open Access 01-12-2017 | Preliminary research

Hepatobiliary scintigraphy may improve radioembolization treatment planning in HCC patients

Authors: Manon N. G. J. A. Braat, Hugo W. de Jong, Beatrijs A. Seinstra, Mike V. Scholten, Maurice A. A. J. van den Bosch, Marnix G. E. H. Lam

Published in: EJNMMI Research | Issue 1/2017

Abstract

Background

Routine work-up for transarterial radioembolization, based on clinical and laboratory parameters, sometimes fails, resulting in severe hepatotoxicity in up to 5% of patients. Quantitative assessment of the pretreatment liver function and its segmental distribution, using hepatobiliary scintigraphy may improve patient selection and treatment planning. A case series will be presented to illustrate the potential of this technique.

Hepatocellular carcinoma patients with cirrhosis (Child-Pugh A and B) underwent hepatobiliary scintigraphy pre- and 3 months post-radioembolization as part of a prospective study protocol, which was prematurely terminated because of limited accrual. Included patients were analysed together with their clinical, laboratory and treatment data.

Results

Pretreatment-corrected ^99mTc-mebrofenin liver uptake rates were marginal (1.8–3.0%/min/m²), despite acceptable clinical and laboratory parameters. Posttreatment liver functions seriously declined (corrected ^99mTc-mebrofenin liver uptake rates: 0.6–2.4%/min/m²), resulting in lethal radioembolization-induced liver disease in two out of three patients.

Conclusions

Hepatobiliary scintigraphy may be of added value during work-up for radioembolization, to estimate liver function reserve and its segmental distribution, especially in patients with underlying cirrhosis, for whom analysis of clinical and laboratory parameters may not be sufficient.

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Title: Hepatobiliary scintigraphy may improve radioembolization treatment planning in HCC patients
Authors: Manon N. G. J. A. Braat
Hugo W. de Jong
Beatrijs A. Seinstra
Mike V. Scholten
Maurice A. A. J. van den Bosch
Marnix G. E. H. Lam
Publication date: 01-12-2017
Publisher: Springer Berlin Heidelberg
Published in: EJNMMI Research / Issue 1/2017
Electronic ISSN: 2191-219X
DOI: https://doi.org/10.1186/s13550-016-0248-x

At a glance: The STEP trials

Springer Medicine

Hepatobiliary scintigraphy may improve radioembolization treatment planning in HCC patients

Abstract

Background

Results

Conclusions

At a glance: The STEP trials

Springer Medicine

Abstract

Background

Results

Conclusions

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