| Biodistribution et dosimétrie chez des patients porteurs d’un carcinome hépatocellulaire traités par 188Re-SSS Lipiodol (Biodistribution and dosimetry assessments in patients with hepatocellular carcinoma treated with 188Re-SSS Lipiodol) Delaunay, Kostas - (2018-07-05) / Universite de Rennes 1 - Biodistribution et dosimétrie chez des patients porteurs d’un carcinome hépatocellulaire traités par 188Re-SSS Lipiodol
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Langue : Anglais Directeur(s) de thèse: Garin, Etienne Discipline : Médecine nucléaire Classification : Médecine et santé Mots-clés : Radioembolization, 188Re-SSS Lipiodol, 188Rhénium, Lipiodol, Hepatocellular carcinoma, Radiolabeled lipiodol, Internal radiotherapy, HCC
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Résumé : Introduction: The goal of this study is to provide preliminary results about the biodistribution, and dosimetry after intra-arterial liver injection of 188Re-SSS Lipiodol for hepatocellular carcinoma patients included in the phase one study Lip-Re 1. Methods: Results of the first 6 included patients are reported. Analysis of the biodistribution of the 188Re-SSS Lipiodol was based on planar scintigraphic and tomoscintigraphic (SPECT) studies performed at 1, 6, 24, 48 and 72 hours post administration. Quantification in blood samples, urinary excretion and in feces was performed. Determination of the Tumor to Non Tumor higher uptake ratio (T/NT) was also calculated. Absorbed doses to target organs and tumors were evaluated using the MIRD formalism. Results: The mean injected activity of 188Re-SSS Lipiodol was 1581+/-414 MBq. Uptakes were seen in liver (tumor and healthy liver) and in lungs only. All these uptakes were stable during time. A mean amount of 1,40+/-0,75 % of 188Re-SSS Lipiodol administered was excreted in serum samples at 6 hours then declined rapidly. A mean of only 1,51+/-1,57 % of the administered activity was eliminated in urines and in feces over 72 hours. 90.66 +/- 1.59 % of detected activity on SPECT studies was in liver (74.93+/-1.8 % in tumors and 19.09 +/- 1.70 % in the healthy liver), and 9.33+/-1.61 % were in lungs (with respectively 5.66 +/- 1.11 % in right lung and 3.66+/- 0.51 % in left lung). Mean absorbed doses were 8,42+/-3,87 Gy to the whole liver ; 45.61+/-36.27 Gy to the tumors ; 2.51+/-1.85 Gy to the healthy liver and 1.60 +/- 0.98 Gy to the lungs. Four patients had stable disease on CT scans at 2 months, no limiting toxicity was reported. Conclusion: 188Re-SSS Lipiodol has a favorable biodistribution for radioembolization with especially the highest in vivo stability of any radiolabeled Lipiodol compound describe to date. No limiting toxicity was reported at this step of the phase 1. Abstract : Introduction: The goal of this study is to provide preliminary results about the biodistribution, and dosimetry after intra-arterial liver injection of 188Re-SSS Lipiodol for hepatocellular carcinoma patients included in the phase one study Lip-Re 1. Methods: Results of the first 6 included patients are reported. Analysis of the biodistribution of the 188Re-SSS Lipiodol was based on planar scintigraphic and tomoscintigraphic (SPECT) studies performed at 1, 6, 24, 48 and 72 hours post administration. Quantification in blood samples, urinary excretion and in feces was performed. Determination of the Tumor to Non Tumor higher uptake ratio (T/NT) was also calculated. Absorbed doses to target organs and tumors were evaluated using the MIRD formalism. Results: The mean injected activity of 188Re-SSS Lipiodol was 1581+/-414 MBq. Uptakes were seen in liver (tumor and healthy liver) and in lungs only. All these uptakes were stable during time. A mean amount of 1,40+/-0,75 % of 188Re-SSS Lipiodol administered was excreted in serum samples at 6 hours then declined rapidly. A mean of only 1,51+/-1,57 % of the administered activity was eliminated in urines and in feces over 72 hours. 90.66 +/- 1.59 % of detected activity on SPECT studies was in liver (74.93+/-1.8 % in tumors and 19.09 +/- 1.70 % in the healthy liver), and 9.33+/-1.61 % were in lungs (with respectively 5.66 +/- 1.11 % in right lung and 3.66+/- 0.51 % in left lung). Mean absorbed doses were 8,42+/-3,87 Gy to the whole liver ; 45.61+/-36.27 Gy to the tumors ; 2.51+/-1.85 Gy to the healthy liver and 1.60 +/- 0.98 Gy to the lungs. Four patients had stable disease on CT scans at 2 months, no limiting toxicity was reported. Conclusion: 188Re-SSS Lipiodol has a favorable biodistribution for radioembolization with especially the highest in vivo stability of any radiolabeled Lipiodol compound describe to date. No limiting toxicity was reported at this step of the phase 1. | |||