{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,11]],"date-time":"2026-08-11T10:39:26Z","timestamp":1786444766203,"version":"build-2736575974"},"reference-count":26,"publisher":"Springer Science and Business Media LLC","issue":"2","license":[{"start":{"date-parts":[[2024,9,27]],"date-time":"2024-09-27T00:00:00Z","timestamp":1727395200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2024,9,27]],"date-time":"2024-09-27T00:00:00Z","timestamp":1727395200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"name":"BTG International\/Boston Scientific Corporation","award":["BTG International\/Boston Scientific Corporation"],"award-info":[{"award-number":["BTG International\/Boston Scientific Corporation"]}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Eur J Nucl Med Mol Imaging"],"published-print":{"date-parts":[[2025,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n          <jats:sec>\n            <jats:title>Purpose<\/jats:title>\n            <jats:p>Pre-treatment [<jats:sup>99m<\/jats:sup>Tc]TcMAA-based radioembolization treatment planning using multicompartment dosimetry involves the definition of the tumor and normal tissue compartments and calculation of the prescribed absorbed doses. The aim was to compare the real-world utility of anatomic and [<jats:sup>99m<\/jats:sup>Tc]TcMAA-based segmentation of tumor and normal tissue compartments.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Materials and methods<\/jats:title>\n            <jats:p>Included patients had HCC treated by glass [<jats:sup>90<\/jats:sup>Y]yttrium microspheres, \u2265\u20091 tumor, \u2265\u20093\u00a0cm diameter and [<jats:sup>99m<\/jats:sup>Tc]TcMAA SPECT\/CT imaging before treatment. Segmentation was performed retrospectively using dedicated dosimetry software: (1) anatomic (diagnostic CT\/MRI-based), and (2) [<jats:sup>99m<\/jats:sup>Tc]TcMAA threshold-based (i.e., using an activity-isocontour threshold). CT\/MRI was co-registered with [<jats:sup>99m<\/jats:sup>Tc]TcMAA SPECT\/CT. Logistic regression and Cox regression, respectively, were used to evaluate relationships between total perfused tumor absorbed dose (TAD) and objective response rate (ORR) and overall survival (OS). In a subset-analysis pre- and post-treatment dosimetry were compared using Bland-Altman analysis and Pearson\u2019s correlation coefficient.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Results<\/jats:title>\n            <jats:p>A total of 209 patients were enrolled. Total perfused tumor and normal tissue volumes were larger when using anatomic versus [<jats:sup>99m<\/jats:sup>Tc]TcMAA threshold segmentation, resulting in lower absorbed doses. mRECIST ORR was higher with increasing total perfused TAD (odds ratio per 100\u00a0Gy TAD increase was 1.22 (95% CI: 1.01\u20131.49; <jats:italic>p<\/jats:italic>\u2009=\u20090.044) for anatomic and 1.19 (95% CI: 1.04\u20131.37; <jats:italic>p<\/jats:italic>\u2009=\u20090.012) for [<jats:sup>99m<\/jats:sup>Tc]TcMAA threshold segmentation. Higher total perfused TAD was associated with improved OS (hazard ratio per 100\u00a0Gy TAD increase was 0.826 (95% CI: 0.714\u20130.954; <jats:italic>p<\/jats:italic>\u2009=\u20090.009) and 0.847 (95% CI: 0.765\u20130.936; <jats:italic>p<\/jats:italic>\u2009=\u20090.001) for anatomic and [<jats:sup>99m<\/jats:sup>Tc]TcMAA threshold segmentation, respectively). For pre- vs. post-treatment dosimetry comparison, the average bias for total perfused TAD was +\u200911.5\u00a0Gy (95% limits of agreement: -227.0 to 250.0) with a strong positive correlation (Pearson\u2019s correlation coefficient\u2009=\u20090.80).<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Conclusion<\/jats:title>\n            <jats:p>Real-world data support [<jats:sup>99m<\/jats:sup>Tc]TcMAA imaging to estimate absorbed doses prior to treatment of HCC with glass [<jats:sup>90<\/jats:sup>Y]yttrium microspheres. Both anatomic and [<jats:sup>99m<\/jats:sup>Tc]TcMAA threshold methods were suitable for treatment planning.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Trial registration number<\/jats:title>\n            <jats:p>NCT03295006.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1007\/s00259-024-06920-6","type":"journal-article","created":{"date-parts":[[2024,9,27]],"date-time":"2024-09-27T04:02:10Z","timestamp":1727409730000},"page":"744-755","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Utility of pre-procedural [99mTc]TcMAA SPECT\/CT Multicompartment Dosimetry for Treatment Planning of 90Y Glass microspheres in patients with Hepatocellular Carcinoma: comparison of anatomic versus [99mTc]TcMAA-based Segmentation"],"prefix":"10.1007","volume":"52","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4902-9790","authenticated-orcid":false,"given":"Marnix","family":"Lam","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Etienne","family":"Garin","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paul","family":"Haste","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alban","family":"Denys","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Brian","family":"Geller","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"S. 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He receives research support from Boston Scientific, Terumo and Quirem Medical. The UMC Utrecht receives royalties from Quirem Medical.Etienne Garin, MD, PhD: Serves as a consultant for Boston Scientific.Paul Haste, MD: Is a consultant for Boston Scientific.Alban Denys, MD, MSc: Is a consultant for Cook, Neuwave, and received grants from Johnson and Johnson.Brian Geller, MD: Nothing to disclose.S. Cheenu Kappadath, PhD: Is a consultant for Boston Scientific, Sirtex Medical, and Terumo Medical. He receives research support from Boston Scientific, Sirtex Medical and ABK Biomedical.Cuneyt Turkmen, MD: Is a consultant for Boston Scientific.Daniel Y Sze, MD, PhD: Was a consultant for Argon, Artio Medical, Astra-Zeneca, Bayer, BlackSwan Vascular, Boston Scientific, Bristol Meyers Squibb, Eisai, FludX, W.L. Gore, Guerbet, Koli, Sirtex, Terumo, TriSalus, and Varian; received institutional research support from Boston Scientific, W.L. Gore, Merit Medical, and Sirtex; held equity in BlackSwan Vascular, Confluent Medical, Koli, Proteus Digital Health, Radiaction, and TriSalus; and serves on data safety monitoring boards for W.L. Gore and Replimune.Hamad Saleh Alsuhaibani, MD: Nothing to disclose.Ken Herrmann, MD: Reports personal fees from Bayer, personal fees and other from Sofie Bioscienes, personal fees from SIRTEX, non-financial support from ABX, personal fees from Adacap, personal fees from Curium, personal fees from Endocyte, grants and personal fees from Boston Scientific, personal fees from IPSEN, personal fees from Siemens Healthineers, personal fees from GE Healthcare, personal fees from Amgen, personal fees from Novartis, personal fees from ymabs, personal fees from Aktis Oncology, personal fees from Theragnostics, personal fees from Pharma15, outside the submitted work.Marco Maccauro, MD: Nothing to disclose.Murat Cantasdemir, MD: Is a consultant for Boston Scientific.Matthew Dreher, PhD: Works for Boston Scientific.Kirk D. Fowers, PhD: Works for Boston Scientific.Vanessa Gates, PhD: Is a consultant for Boston Scientific. Riad Salem, MD: Is a consultant for Boston Scientific, AstraZeneca, Genentech, Sirtex, Cook, Eisai, Bard and QED Therapeutics.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflicts of Interest\/Competing interests"}},{"value":"Not Applicable.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval"}},{"value":"Not Applicable.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent to participate"}}]}}