Study completed. View publication by Smits et al. in Lancet Oncology on Pubmed (External link)
Clinicaltrials.gov Identifier NCT01031784 (External link)
Study completed. View publication by Prince et al. in Journal of Nuclear Medicine on Pubmed (External link)
Clinicaltrials.gov Identifier NCT01612325 (External link)
Results
Conclusion
Clinicaltrials.gov Identifier NCT02067988 (External link)
Study completed. View publication by Braat et al. in the Lancet Oncology
Principal Investigator: Mark. C. Burgmans, MD, PhD, Leiden UMC
Clinicaltrials.gov Identifier NCT03437382 (External link)
Objectives:
Principal Investigator: Marnix G. Lam, MD, PhD, UMC Utrecht
Clinicaltrials.gov Identifier NCT03379844 (External link)
HEPAR I
Single Center Phase I – Dose Escalation Study
Results
Conclusion
HEPAR II
Single Center Phase II – Safety & Efficacy Study
Results
Conclusion
Single Center Retrospective Study
Results
Conclusion
HEPAR PLuS
Additional Holmium-166 SIRT after Lutetium-166 dotatate in patients with neuroendocrine tumor liver metastases
Single center, single-arm, open label phase 2 study
Results
A quantitative evaluation in patients treated with 166Ho-microspheres to compare the performance of pretreatment diagnostic 99mTc-MAA imaging and pretreatment diagnostic 166Ho microsphere imaging for lung absorbed dose estimation in 166Ho radioembolization.
Results
Conclusion
To retrospectively study the safety of Holmium-166 microspheres as scout dose before treatment with QuiremSpheres®
Results
Conclusions:
The aim of this study was to analyze whether the intrahepatic distribution of 166Ho-scout has a better agreement with the 166Ho-therapeutic dose distribution in comparison with 99mTc-MAA.
Conclusion
Based on the combined results of the quantitative and qualitative analyses, 166Ho-scout was shown to have a superior predictive value for intrahepatic distribution in comparison with 99mTc-MAA.
This editorial concerns the publications on 166Ho scout and comparisons of 166Ho scout with 99mTc-MAA.
The authors highlight the differences between MAA prediction and the actual microsphere distribution of 90Yttrium microspheres. There can be many reasons for discrepancy between the two, but differences in number and size of MAA and microspheres are an important factor. With respect to lung shunt prediction, it is well known that MAA can break up in small pieces that physiologically shunt to the lungs, thereby overestimating the potential lungshunt.
The authors further comment on the recurring finding that prediction of normal liver dose is more reliable than prediction of tumor dose and is likely impacted by image co-registration and delineation of volumes. Furthermore, the impact of catheter placement, type of catheter or vasospasm are still limitations.
Regardless, the authors clearly conclude that 166Ho scout is the ‘best particle’ for individual treatment planning, both in liver and lungs.
A 61-year old male patient was diagnosed with right colon adenocarcinoma three years ago (G2, pT3N2, KRAS mut) and liver metastasis one year later. He was treated previously with right hepatectomy and percutaneous ablation. SIRT was approved by multidisciplinary tumor board. Post-treatment SPECT-CT showed excellent concentration of the microspheres in the liver lesions. Use the slider to compare the baseline 18FDG-PET and post-therapy SPECT/CT images.
Click below to read more about this case.
a 47-yo FEmale metastatic colorectal cancer-patient
A 47-years old female patient diagnosed with left colon adenocarcinoma and synchronous hepatic metastasis three years before, treated with multiple hepatic resections, percutaneous ablation and >3 lines of systemic chemotherapy. Patient presents with mild hepatic progression (ECOG 0, normal liver function). SIRT was approved by multidisciplinary tumor board. Post-treatment T2* MRI showed excellent concentration of the microspheres in the liver lesions. Fourty-five days after SIRT, CT demonstrated reduction in size of the majority of the hepatic lesions, the largest showing peripheral calcifications.
Click below to read more about this case.
a 64-yo male metastatic colorectal cancer-patient
A 64-year old male patient with a history of metastatic colorectal cancer (mCRC) was diagnosed two years before and treated by resection of liver segments II and III and IVb. Systemic chemotherapy was given until current diagnosis of multiple advanced unresectable liver metastases. SIRT was approved by the multidisciplinary tumor board for further volume reduction of the liver metastases. At 5 months follow-up, excellent tumor response was seen on contrast enhanced CT. Post-treatment MR imaging was not available.
Use the slider to switch between the baseline contrast enhanced MRI and follow-up contrast enhanced CT images.
Click below to read more about this case.
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