Impact of contouring methods on pre-treatment and post-treatment dosimetry for the prediction of tumor control and survival in HCC patients treated with selective internal radiation therapy - Université de Bourgogne Accéder directement au contenu
Article Dans Une Revue EJNMMI Research Année : 2021

Impact of contouring methods on pre-treatment and post-treatment dosimetry for the prediction of tumor control and survival in HCC patients treated with selective internal radiation therapy

Guillaume Nodari
Jean Marc Riedinger
  • Fonction : Auteur
Olivier Lopez
  • Fonction : Auteur
Julie Pellegrinelli
  • Fonction : Auteur
Inna Dygai-Cochet
  • Fonction : Auteur
Claire Tabouret-Viaud
  • Fonction : Auteur
Olivier Chevallier
Sophie Gehin
  • Fonction : Auteur
Matthieu Gallet
  • Fonction : Auteur
Marianne Latournerie
  • Fonction : Auteur
Sylvain Manfredi
  • Fonction : Auteur
Romaric Loffroy

Résumé

Abstract Introduction The aim of this study was to evaluate the impact of the contouring methods on dose metrics and their predictive value on tumor control and survival, in both situations of pre-treatment and post-treatment dosimetry, for patients with advanced HCC treated with SIRT. Methods Forty-eight patients who underwent SIRT between 2012 and 2020 were retrospectively included in this study. Target volumes were delineated using two methods: MRI-based contours manually drawn by a radiologist and then registered on SPECT/CT and PET/CT via deformable registration (Pre-C MRI and Post-C MRI ), 99m Tc-MAA-SPECT and 90 Y-microspheres-PET 10% threshold contouring (Pre-C SPECT and Post-C PET ). The mean absorbed dose (Dm) and the minimal absorbed dose delivered to 70% of the tumor volume (D70) were evaluated with both contouring methods; the tumor-to-normal liver uptake ratio (TNR) was evaluated with MRI-based contours only. Tumor response was assessed using the mRECIST criteria on the follow-up MRIs. Results No significant differences were found for Dm and TNR between pre- and post-treatment. TNR evaluated with radiologic contours (Pre-C MRI and Post-C MRI ) were predictive of tumor control at 6 months on pre- and post-treatment dosimetry (OR 5.9 and 7.1, respectively; p = 0.02 and 0.01). All dose metrics determined with both methods were predictive of overall survival (OS) on pre-treatment dosimetry, but only Dm with MRI-based contours was predictive of OS on post-treatment images with a median of 23 months for patients with a supramedian Dm versus 14 months for the others ( p = 0.04). Conclusion In advanced HCC treated with SIRT, Dm and TNR determined with radiologic contours were predictive of tumor control and OS. This study shows that a rigorous clinical workflow (radiologic contours + registration on scintigraphic images) is feasible and should be prospectively considered for improving therapeutic strategy.

Dates et versions

hal-03611621 , version 1 (17-03-2022)

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Citer

Guillaume Nodari, Romain Popoff, Jean Marc Riedinger, Olivier Lopez, Julie Pellegrinelli, et al.. Impact of contouring methods on pre-treatment and post-treatment dosimetry for the prediction of tumor control and survival in HCC patients treated with selective internal radiation therapy. EJNMMI Research, 2021, 11 (1), pp.24. ⟨10.1186/s13550-021-00766-x⟩. ⟨hal-03611621⟩
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