1. Histopathologic Changes after Yttrium-90 Radioembolization of Colorectal Liver Metastases: A Pilot Feasibility Study.
- Author
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Kitsel Y, Vakiani E, Kirov A, Zirakchian Zadeh M, Kunin H, Petre EN, Crane CH, Romesser P, Sotirchos VS, and Sofocleous CT
- Subjects
- Humans, Pilot Projects, Male, Female, Middle Aged, Prospective Studies, Aged, Treatment Outcome, Time Factors, Image-Guided Biopsy, Cell Proliferation, Ki-67 Antigen metabolism, DNA Breaks, Double-Stranded, Biomarkers, Tumor metabolism, Yttrium Radioisotopes administration & dosage, Liver Neoplasms radiotherapy, Liver Neoplasms secondary, Liver Neoplasms diagnostic imaging, Liver Neoplasms pathology, Colorectal Neoplasms pathology, Embolization, Therapeutic, Radiopharmaceuticals administration & dosage, Feasibility Studies, Positron Emission Tomography Computed Tomography
- Abstract
Purpose: To evaluate the histopathologic changes and potential correlations of tumor absorbed dose (TAD) after yttrium-90 transarterial radioembolization (TARE) for colorectal liver metastases (CLMs)., Materials and Methods: This prospective pilot study assessed 12 patients with 13 CLMs through positron emission tomography (PET)/computed tomography (CT)-guided biopsies before, immediately after TARE (T0), and 3 weeks after TARE (T3). Subsequent sampling from the same location was enabled by fiducial placement. Biopsy samples were evaluated with hematoxylin and eosin, TUNEL, Ki67, OxPhos, caspase-3 (CC3), and pH2AX antibodies. Proliferation changes (Ki67) and double-strand DNA breaks (DSBs) were evaluated quantitatively. TAD was calculated on post-TARE PET/CT scan of the biopsy needle location at T0 and T3., Results: Median TAD at 3 weeks after TARE was 162 Gy (interquartile range (IQR), 92-211 Gy). DSBs decreased significantly from T0 (median, 77%; IQR, 75%-100%) to T3 (median, 14%; IQR, 0%-54%; P = .028). A decrease in Ki67 was also documented (median, 73%; IQR, 70%-80% at T0 vs median, 41%; IQR, 0%-66% at T3; P = .046). There was a strong positive correlation between TAD and DSBs at T0 (r[9] = 0.68) and a strong negative correlation at T3 (r[10] = -0.855; P = .042 and P = .002, respectively). There was a strong negative correlation between TAD and Ki67 at both T0 (r[9] = -0.733; P = .025) and T3 (r[10] = -0.681; P = .030). Tumors that exhibited caspase-3 activation (8/13, 62%) at either T0 or T3 time point were more likely to develop progression (7/8 [88%] vs 1/5 [20%]; P = .015)., Conclusions: Post-TARE biopsy can be used to assess TAD and histopathologic changes. Significant decreases in DSBs and proliferation index were noted after TARE. Post-TARE CC3 activation deserves further exploration., (Copyright © 2024 SIR. Published by Elsevier Inc. All rights reserved.)
- Published
- 2024
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