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Clinical Trial
. 2013 Mar;23(3):827-35.
doi: 10.1007/s00330-012-2648-2. Epub 2012 Sep 27.

MRI-based biodistribution assessment of holmium-166 poly(L-lactic acid) microspheres after radioembolisation

Gerrit H van de Maat  1 , Peter R Seevinck, Mattijs Elschot, Maarten L J Smits, Hendrik de Leeuw, Alfred D van Het Schip, Maarten A D Vente, Bernard A Zonnenberg, Hugo W A M de Jong, Marnix G E H Lam, Max A Viergever, Maurice A A J van den Bosch, Johannes F W Nijsen, Chris J G Bakker
Affiliations
Clinical Trial

MRI-based biodistribution assessment of holmium-166 poly(L-lactic acid) microspheres after radioembolisation

Gerrit H van de Maat et al. Eur Radiol. 2013 Mar.

Abstract

Objectives: To demonstrate the feasibility of MRI-based assessment of the intrahepatic Ho-PLLA-MS biodistribution after radioembolisation in order to estimate the absorbed radiation dose.

Methods: Fifteen patients were treated with holmium-166 ((166)Ho) poly(L-lactic acid)-loaded microspheres (Ho-PLLA-MS, mean 484 mg; range 408-593 mg) in a phase I study. Multi-echo gradient-echo MR images were acquired from which R (2) maps were constructed. The amount of Ho-PLLA-MS in the liver was determined by using the relaxivity r (2) of the Ho-PLLA-MS and compared with the administered amount. Quantitative single photon emission computed tomography (SPECT) was used for comparison with MRI regarding the whole liver absorbed radiation dose.

Results: R (2) maps visualised the deposition of Ho-PLLA-MS with great detail. The mean total amount of Ho-PLLA-MS detected in the liver based on MRI was 431 mg (range 236-666 mg) or 89 ± 19 % of the delivered amount (correlation coefficient r = 0.7; P < 0.01). A good correlation was found between the whole liver mean absorbed radiation dose as assessed by MRI and SPECT (correlation coefficient r = 0.927; P < 0.001).

Conclusion: MRI-based dosimetry for holmium-166 radioembolisation is feasible. Biodistribution is visualised with great detail and quantitative measurements are possible.

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Figures

Fig. 1
Fig. 1
R2 * maps and SE images (TR/TE: 830 ms/80 ms, flip angle: 90°) before (a + b) and after (c + d) RE. Variations in R2* values before RE (a) correspond to variations on SE images (b). After RE, increased R2* values were observed at locations with Ho-PLLA-MS deposition (c), corresponding to tumour lesions with high intensities on SE images (arrows) (d)
Fig. 2
Fig. 2
Typical histogram of R2* values measured in the whole liver of a patient before (– –) and after (―) adminstration of Ho-PLLA-MS. After administration the curves shifted toward higher values and a broader distribution of R2* values was observed
Fig. 3
Fig. 3
MRI-based concentration maps (a) after Ho-PLLA-MS administration, MRI-based absorbed dose maps (b) together with their corresponding SPECT images (c) and T1-weighted images (d) (TR/TE: 8.5 ms/4.18 ms, flip angle: 10°). The concentration maps were constructed from normalised R2* maps by using the r2* relaxivity of Ho-PLLA-MS. MRI-based dose maps were constructed by applying a dose point kernel after conversion of concentrations Ho-PLLA-MS to MBq/voxel. MRI-based concentration and absorbed dose correspond to the activity distribution on the SPECT images (c) and the tumour sites on T1-weighted images (d) (arrows)
Fig. 4
Fig. 4
MRI-based Ho-PLLA-MS concentration maps before (a) and after (b) radioembolisation in a patient with multiple surgical clips after partial liver resection. At the location of the clips (arrows), quantification failed (black spots), while in the near vicinity extremely high concentration values were found (white rings)
Fig. 5
Fig. 5
Ho-PLLA-MS deposition around tumours. MRI-based concentration maps (a) show more detail (higher resolution) about the distribution of the microspheres than the SPECT-based activity maps. The Ho-PLLA-MS are primarily distributed in the peripheral parts of the tumour (a). This is less pronounced on the SPECT images (b)
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