Safety and Feasibility of Interventional Hybrid Fluoroscopy and Nuclear Imaging in the Work-up Procedure of Hepatic Radioembolization
Dietze, Martijn M.A., Meddens, Marjolein B.M., van Rooij, Rob, Braat, Arthur J.A.T., de Keizer, Bart, Bruijnen, Rutger C.G., Lam, Marnix G.E.H., Smits, Maarten L.J., de Jong, Hugo W.A.M.
DOI: https://doi.org/10.1148/rycan.240044
Radiology. Imaging cancer 6 (6),
Abstract
Purpose: To evaluate the safety and feasibility of a novel hybrid nuclear and fluoroscopy C-arm scanner to be used during the work-up procedure of hepatic radioembolization. Materials and Methods: In this prospective first-in-human clinical study, 12 participants (median age, 67 years [range: 37–78 years]; nine [75%] male, three [25%] female) with liver tumors undergoing work-up for yttrium 90 radioembolization were included (ClinicalTrials.gov NCT06013774). Work-up angiography and technetium 99m–macroaggregated albumin injection were performed in an angiography suite equipped with a hybrid C-arm that could simultaneously perform fluoroscopy and planar nuclear imaging. Technetium 99m–macroaggregated albumin was injected under real-time hybrid imaging, followed by in-room SPECT imaging. Safety and feasibility were studied by assessing adverse events, technical performance, additional x-ray radiation dose, and questionnaires completed by radiologists and technologists. Results: No adverse events were attributed to the hybrid C-arm scanner. The additional x-ray radiation dose was low (median, 19 Gy ∙ cm2; minimum: 12 Gy ∙ cm2; maximum: 21 Gy ∙ cm2 for participants who completed all imaging steps). The interventional personnel considered use of the hybrid C-arm scanner safe and feasible, although the additional time spent in the intervention room was considered long (median, 64 minutes; minimum: 55 minutes; maximum: 77 minutes for participants who completed all imaging steps). Conclusion: Use of the hybrid C-arm scanner during the work-up procedure of hepatic radioembolization was found to be safe and feasible in this first-inhuman clinical study. Supplemental material is available for this article.