Cargando…

Hepatobiliary scintigraphy may improve radioembolization treatment planning in HCC patients

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 sc...

Descripción completa

Detalles Bibliográficos
Autores principales: Braat, Manon N. G. J. A., de Jong, Hugo W., Seinstra, Beatrijs A., Scholten, Mike V., van den Bosch, Maurice A. A. J., Lam, Marnix G. E. H.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Springer Berlin Heidelberg 2017
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5215993/
https://www.ncbi.nlm.nih.gov/pubmed/28058660
http://dx.doi.org/10.1186/s13550-016-0248-x
Descripción
Sumario: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 (99m)Tc-mebrofenin liver uptake rates were marginal (1.8–3.0%/min/m(2)), despite acceptable clinical and laboratory parameters. Posttreatment liver functions seriously declined (corrected (99m)Tc-mebrofenin liver uptake rates: 0.6–2.4%/min/m(2)), 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.