Effects of dose heterogeneity on response and toxicity after 90Y-SIRT for HCC

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Key Points

The study aims to understand how voxel-based dose heterogeneity impacts tumor response and toxicity in SIRT for HCC.
Evaluated voxel-based dose metrics from Y PET/CT scans including hot-spot and cold-spot parameters.
Used mRECIST to assess tumor response and classified toxicity into acute and latent based on severity.
Stratified lesions by median absorbed dose (D50 < 128 Gy vs. ≥ 128 Gy).
44% of 68 lesions achieved complete response.
Higher dose heterogeneity in low-D50 lesions improved response, while cold-spot metrics in high-D50 lesions showed significant associations with better outcomes.
Mean non-tumoral liver dose correlated with acute toxicity, while dose heterogeneity linked to latent toxicity.

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Evaluates voxel-based dose heterogeneity's impact on tumour response and toxicity in hepatocellular carcinoma, indicating treatment personalization.

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Xi et al. (2026) studied this question.

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