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• W2410461073 abstract "298 Objectives 90Y-microsphere therapy is used in treatment of unresectable hepatocellular carcinoma (HCC). We calculated 3D dose distributions based on post-therapy quantitative 90Y SPECT/CT to assess the efficacy of voxel-based absorbed doses (AD) as predictors of HCC tumor response. The tumor dose response model predictions were validated using independent data. Normal liver AD were also computed and correlated with incidence of radio-embolization induced liver disease (REILD). Methods 90Y activity for 34 HCC patient therapies was prospectively calculated using package insert dosimetry. Voxel dosimetry for AD to tumor and non-tumoral liver volumes was performed retrospective using 90Y activity and tissue/density distributions based on quantitative post-therapy 90Y SPECT/CT. Tumor (D>2.5cm; N=53) segmentation was performed by an interventional radiologist using diagnostic CT/MRI of the liver registered to 90Y SPECT/CT. AD maps were generated using the radiation transport code DOSXYZnrc/EGSnrc. Tumor volume coverage metrics (10% to 100% volume) were extracted from cumulative AD volume histograms (ADVH). Tumor response was evaluated using mRECIST, WHO, and RECIST with binary outcome; non-responders (NR=PD+SD) and responders (R=PR+CR). Correlation of tumor AD metrics with response status was explored. Logistic regression was used to calculate tumor dose-response probability curves. Threshold mean AD to tumor for 50% probability of response using mRECIST (D50p) was computed. Logistic regression analysis was performed for all (N=53) and two independent halves (N1=27 and N2=26) of the tumor population. The validity and robustness of the predicted accuracy, positive-predictive value (PPV), and negative predictive value (NPV) of tumor dose response was assessed using the two independent N1 and N2 populations. Fractional non-tumoral liver volumes receiving AD>30 Gy (V30Gy) were calculated for all patients. Distribution of V30Gy and its correlation with incidence of REILD (e.g., ascites) were assessed. Results Response fractions were 30/53, 14/53, and 15/53 for mRECIST, WHO, and RECIST, respectively. ADVHs (10-90%) were significantly correlated (p Conclusions For HCC tumors voxel-based AD statistically separated mRECIST responders. The tumor dose response probability curves calculated appear robust and are statistically consistent when response predictions were compared to independent data. Tumor dose response probability curves can now confidently be used to prospectively plan therapies. Additional data will be needed to correlate non-tumoral AD with REILD.Research Support: NIH/NCI R01 CA138986" @default.
• W2410461073 created "2016-06-24" @default.
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• W2410461073 date "2016-05-01" @default.
• W2410461073 modified "2023-09-23" @default.
• W2410461073 title "HCC tumor dose response characterization following 90Y-microsphere therapy" @default.
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