Histopathologic changes after yttrium-90 radioembolization of colorectal liver metastases: A pilot feasibility study Journal Article
| Authors: | Kitsel, Y.; Vakiani, E.; Kirov, A.; Zirakchian Zadeh, M.; Kunin, H.; Petre, E. N.; Crane, C. H.; Romesser, P.; Sotirchos, V. S.; Sofocleous, C. T. |
| Article Title: | Histopathologic changes after yttrium-90 radioembolization of colorectal liver metastases: A pilot feasibility study |
| 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. © 2024 SIR |
| Keywords: | immunohistochemistry; clinical article; human tissue; histopathology; cancer growth; antineoplastic agent; technetium 99m; ki 67 antigen; radiotherapy dosage; caspase 3; enzyme activation; feasibility study; pilot study; needle biopsy; double stranded dna break; histone h2ax; oxidative phosphorylation; clinical outcome; yttrium 90; radioembolization; colorectal liver metastasis; human; male; female; article; tunel assay; positron emission tomography-computed tomography |
| Journal Title: | Journal of Vascular and Interventional Radiology |
| Volume: | 35 |
| Issue: | 7 |
| ISSN: | 1051-0443 |
| Publisher: | Elsevier Science, Inc. |
| Date Published: | 2024-07-01 |
| Start Page: | 1012 |
| End Page: | 1021.e1 |
| Language: | English |
| DOI: | 10.1016/j.jvir.2024.04.010 |
| PUBMED: | 38670528 |
| PROVIDER: | scopus |
| DOI/URL: | |
| Notes: | Article -- MSK Cancer Center Support Grant (P30 CA008748) acknowledged in PDF -- MSK corresponding author is Constantinos T. Sofocleous -- Source: Scopus |
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