Correlation and Agreement of Yttrium-90 Positron Emission Tomography/Computed Tomography with Ex Vivo Radioembolization Microsphere Deposition in the Rabbit VX2 Liver Tumor Model

Andrew C. Gordon*, Vanessa L. Gates, Sarah B. White, Kathleen R. Harris, Daniel Procissi, Zhuoli Zhang, Weiguo Li, Donald Samaan, Jodi R. Nicolai, Samdeep K. Mouli, Kent T. Sato, Robert K. Ryu, Reed A. Omary, Riad Salem, Robert J. Lewandowski, Andrew C. Larson

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

2 Scopus citations

Abstract

Purpose: To demonstrate a stronger correlation and agreement of yttrium-90 (90Y) positron emission tomography (PET)/computed tomography (CT) measurements with explant liver tumor dosing compared with the standard model (SM) for radioembolization. Materials and Methods: Hepatic VX2 tumors were implanted into New Zealand white rabbits, with growth confirmed by 7 T magnetic resonance imaging. Seventeen VX2 rabbits provided 33 analyzed tumors. Treatment volumes were calculated from manually drawn volumes of interest (VOI) with three-dimensional surface renderings. Radioembolization was performed with glass 90Y microspheres. PET/CT imaging was completed with scatter and attenuation correction. Three-dimensional ellipsoid VOI were drawn to encompass tumors on fused images. Tumors and livers were then explanted for inductively coupled plasma (ICP)-optical emission spectroscopy (OES) analysis of microsphere content. 90Y PET/CT and SM measurements were compared with reference standard ICP-OES measurements of tumor dosing with Pearson correlation and Bland-Altman analyses for agreement testing with and without adjustment for tumor necrosis. Results: The median infused activity was 33.3 MBq (range, 5.9–152.9). Tumor dose was significantly correlated with 90Y PET/CT measurements (r = 0.903, P < .001) and SM estimates (r = 0.607, P < .001). Bland-Altman analyses showed that the SM tended to underestimate the tumor dosing by a mean of −8.5 Gy (CI, −26.3–9.3), and the degree of underestimation increased to a mean of −18.3 Gy (CI, −38.5–1.9) after the adjustment for tumor necrosis. Conclusions: 90Y PET/CT estimates were strongly correlated and had better agreement with reference measurements of tumor dosing than SM estimates.

Original languageEnglish (US)
Pages (from-to)23-32.e1
JournalJournal of Vascular and Interventional Radiology
Volume32
Issue number1
DOIs
StatePublished - Jan 2021

Funding

A.C.L. received grant funding from BTG (investigator-initiated study). S.B.W. is a consultant for Guerbet and receives research support from Siemens and Guerbet . R.J.L. receives research support from R01CA233878-01. R.J.L. and A.C.G. are consultants for ABK. None of the other authors have identified any conflict of interest. Role of Funding: We are grateful for the generous funding provided by the SIR Foundation Allied Scientist Grant (A.C.G.), the Department of Radiology of the Feinberg School of Medicine , and NIH grant R01CA196967-01 . A.C.G. was also supported by the Medical Scientist Training Program ( T32GM008152 ). R.J.L. receives research support from R01CA233878-01. Dose vials, administration kits, and additional funding for research materials were provided by an investigator-initiated study (IIS) grant from BTG. S.B.W. receives salary support from NIH grant 5R25 CA 132822-03 and the RSNA Foundation Research Scholar Grant. The listed authors performed data collection, analysis, and manuscript preparation independently, without assistance from funding sources. A.C.L. received grant funding from BTG (investigator-initiated study). S.B.W. is a consultant for Guerbet and receives research support from Siemens and Guerbet. R.J.L. receives research support from R01CA233878-01. R.J.L. and A.C.G. are consultants for ABK. None of the other authors have identified any conflict of interest.The authors thank Rudiger Laufhutte for performing microsphere digestion and ICP-OES. The authors thank Northwestern University Health Physics (Jose Macatangay, Joseph Princewill, and Thomas E. Whittenhall Jr.) and Northwestern Memorial Hospital Department of Nuclear Medicine (Mike Zimmer, Scott M. Leonard, Peter Cutrera, Lisa Riehle, MacKenzie King, Antonella Guardioloa, Tory Maloy, and Michelle Gruchot). Animal housing and husbandry were provided by the Center for Comparative Medicine (Stephen I. Levin and Giovanni Pompilio). Imaging for our studies was made possible by Northwestern University's Center for Translational Imaging (Daniel Procissi and Sol Misener). Role of Funding: We are grateful for the generous funding provided by the SIR Foundation Allied Scientist Grant (A.C.G.), the Department of Radiology of the Feinberg School of Medicine, and NIH grant R01CA196967-01. A.C.G. was also supported by the Medical Scientist Training Program (T32GM008152). R.J.L. receives research support from R01CA233878-01. Dose vials, administration kits, and additional funding for research materials were provided by an investigator-initiated study (IIS) grant from BTG. S.B.W. receives salary support from NIH grant 5R25 CA 132822-03 and the RSNA Foundation Research Scholar Grant. The listed authors performed data collection, analysis, and manuscript preparation independently, without assistance from funding sources.

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging
  • Cardiology and Cardiovascular Medicine

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