Hepatobiliary Scintigraphy and Glass 90Y Radioembolization with Personalized Dosimetry: Dynamic Changes in Treated and Nontreated Liver

Background: The functional changes that occur over time in the liver following Y-90-radioembolization (RE) using personalized dosimetry (PD) remain to be investigated. Methods: November 2016-October 2019: we retrospectively included hepatocellular carcinoma (HCC) patients treated by Y-90-glass RE using PD, who underwent hepatobiliary scintigraphy (HBS) at baseline and at 15 days, 1, 2, 3, and 6 months after RE. Results: There were 16 patients with unilobar disease (100%) included, and 64 HBS were performed. Whole liver function significantly decreased over time. The loss was maximal at 2 weeks: -32% (p = 0.002) and remained below baseline at 1 (-15%; p = 0.002), 2 (-25%; p < 0.001), and 3 months (-16%; p = 0.027). No radioembolization-induced liver disease was observed. Treated liver function strongly decreased to reach -64% (p < 0.001) at 2 months. Nontreated liver function decreased at 2 weeks (-21%; p = 0.027) and remained below baseline before reaching +20% (p = 0.002) and +59% (p < 0.001) at 3 and 6 months, respectively. Volumetric and functional changes exhibited parallel evolutions in the treated livers (p = 0.01) but independent evolutions in the nontreated livers (p = 0.08). Conclusion: RE using PD induces significant regional changes in liver function over time. As early as 15 days following RE, both the treated and nontreated livers showed a decreased function. Nontreated liver function recovered after 3 months and greatly increased afterwards.