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Peer-reviewedCC BY 4.0European Journal of Nuclear Medicine and Molecular Imaging

Predictive value of [99mTc]Tc-MAA SPECT/CT personalised dosimetry in 90Y radioembolization of hepatocellular carcinoma: a DOSISPHERE-01 ancillary study

  • Grace Keane1,2
  • J Chalaye3
  • B Guiu4
  • L Tselikas5
  • K. D Fowers2
  • E Boucher2
  • E Garin6
  • X Palard6
  • M. G. E. H. Lam1
6 affiliations
  1. 1Department of Radiology and Nuclear Medicine, University Medical Center, Utrecht, 3508 GA The Netherlands
  2. 2Boston Scientific Corporation, Marlborough, MA USA
  3. 3Assistance Publique Hôpitaux de Paris, Paris, France
  4. 4Department of Radiology, St-Eloi University Hospital, Montpellier, France
  5. 5Département d’Anesthésie Chirurgie et Interventionnel, Interventional Radiology unit, Gustave Roussy Université Paris Saclay, Villejuif, France
  6. 6Department of Nuclear Medicine, Centre de Lutte Contre le Cancer Eugène Marquis, Rennes, France
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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.

Supplementary Information: The online version contains supplementary material available at https://doi.org/10.1007/s00259-026-08079-8.

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Cite

BibTeXRIS
BibTeX
@article{keane2026predictive,
  title = {{Predictive value of [99mTc]Tc-MAA SPECT/CT personalised dosimetry in 90Y radioembolization of hepatocellular carcinoma: a DOSISPHERE-01 ancillary study}},
  author = {Grace Keane and J Chalaye and B Guiu and L Tselikas and K. D Fowers and E Boucher and E Garin and X Palard and M. G. E. H. Lam},
  journal = {European Journal of Nuclear Medicine and Molecular Imaging},
  year = {2026},
  month = aug,
  doi = {10.1007/s00259-026-08079-8},
  url = {https://doi.org/10.1007/s00259-026-08079-8},
  note = {CC BY 4.0},
}
RIS
TY  - JOUR
TI  - Predictive value of [99mTc]Tc-MAA SPECT/CT personalised dosimetry in 90Y radioembolization of hepatocellular carcinoma: a DOSISPHERE-01 ancillary study
AU  - Grace Keane
AU  - J Chalaye
AU  - B Guiu
AU  - L Tselikas
AU  - K. D Fowers
AU  - E Boucher
AU  - E Garin
AU  - X Palard
AU  - M. G. E. H. Lam
PY  - 2026
DA  - 2026/08/11
JO  - European Journal of Nuclear Medicine and Molecular Imaging
DO  - 10.1007/s00259-026-08079-8
UR  - https://doi.org/10.1007/s00259-026-08079-8
AB  - 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.  Supplementary Information: The online version contains supplementary material available at https://doi.org/10.1007/s00259-026-08079-8.
SN  - 1619-7070
SN  - 1619-7089
ER  -