Predictive value of [99mTc]Tc-MAA SPECT/CT personalised dosimetry in 90Y radioembolization of hepatocellular carcinoma: a DOSISPHERE-01 ancillary study
In brief
Pre-treatment MAA scan predicts Y-90 dose within ~12 Gy on average
In 37 hepatocellular carcinoma patients, the pre-treatment Tc-99m MAA SPECT/CT dose estimate differed from the post-treatment Y-90 dose by only about 12 Gy for the target lesion, and the two measurements were strongly correlated (r > 0.65). Agreement was best when doses were calculated using anatomic MRI/CT segmentation, supporting MAA-based planning for radioembolization.
- Journal
- European journal of nuclear medicine and molecular imaging (Q1)
- Published
- 11 August 2026
- Study design
- Unclassified
- Evidence level
- Level 5, Expert Opinion (CEBM 5)
- Authors
- Grace Keane, J Chalaye, B Guiu, L Tselikas, K D Fowers, E Boucher, et al.
- PMID
- 42576071
- DOI
- 10.1007/s00259-026-08079-8
Why clinicians should know about it
- Picked for Medical Physics (top studies of the week, 16 August 2026): Predictive vs post‑treatment dosimetry agreement in 90Y radioembolisation
Abstract
PURPOSE: The DOSISPHERE-01 study demonstrated a survival benefit for patients treated with 90Y radioembolization using personalised [99mTc]Tc-MAA guided versus standard dosimetry guided treatment. This ancillary analysis complements DOSISPHERE-01 by reporting post-treatment dosimetry and assessing agreement between predictive ([99mTc]Tc-MAA) and post-treatment (90Y) absorbed doses. MATERIALS AND METHODS: All DOSISPHERE-01 patients with both pre-treatment [99mTc]Tc-MAA SPECT/CT and post-treatment 90Y imaging were eligible. Multicompartment dosimetry was performed using two segmentation methods: anatomic (MRI/CT) and count-threshold based (SPECT). Mean normal liver tissue and index-lesion absorbed dose, and dose volume histogram (DVH) metrics were determined using Simplicit90Y (Mirada Medical, Oxford UK). Agreement between [99mTc]Tc-MAA and 90Y absorbed doses was assessed via Bland-Altman and paired-sample analysis, with correlation assessed via linear-regression. RESULTS: Thirty-seven patients were included: 19 from the personalised arm and 18 from the standard dosimetry arm. Pre- and post-treatment absorbed dose differences were not statistically significant for the index lesion (241 Gy vs. 229 Gy, p = 0.15; mean difference 11.9 Gy; 95% LoA - 84.3 to 108.2 Gy), Perfused Volume Normal Liver Tissue (PVNT) (91 Gy vs. 99 Gy, p = 0.14; mean difference - 8.2 Gy; 95% LoA - 71.6 to 55.1 Gy), or DVH metrics (V200, D70, D50) using anatomic segmentation. Corresponding metrics were significantly different using count-threshold segmentation (p < 0.05). For both methods, pre- and post-treatment mean index lesion and PVNT absorbed doses, and V200, D70, D50 were strongly correlated (Pearsons Correlation Coefficient > 0.65, p < 0.05). CONCLUSION: 90Y absorbed dose outcomes in the DOSISPHERE-01 study corresponded closely with [99mTc]Tc-MAA predictive dosimetry, confirming the validity of [99mTc]Tc-MAA for dosimetry-based treatment planning in this clinical scenario. Agreement was maximised using anatomic segmentation.
Abstract as published, via PubMed.
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