Dosimetry and treatment planning for 90Y-labeled antiferritin in hepatoma.

Radiation absorbed-dose estimates and treatment planning are reported for 11 patients with hepatoma who were administered 90Y-labeled polyclonal antiferritin IgG for therapy in a Phase 1-2 trial. Dosimetric studies included quantitation of the localization and clearance of 111In-labeled antiferritin IgG in tumor and normal tissues and computer-assisted tumor and normal liver volumetrics from X ray CT scans. For the group of patients studied, hepatoma volumes at the time of treatment ranged from 135 to 3442 cm3. Quantitative 111In antiferritin imaging prior to and following 600 or 900 cGy of external-beam irradiation of the primary tumor demonstrated that tumor uptake increased 1.1 to 5.8-fold (mean 2.8) following external beam. In contrast, changes in uptake of radiolabeled antiferritin in normal liver ranged from 0.35 to 2.1-fold (mean 0.93) after external irradiation. Administered activities of 90Y antiferritin ranged from 8 to 37 mCi and were dependent on tumor volume and tumor localization of radiolabeled antiferritin. Following external-beam irradiation, tumor dose rates achieved with 90Y antiferritin ranged from 10 to 20 cGy/hr and normal liver dose rates from 1.1 to 5.7 cGy/h. The corresponding absorbed dose in hepatomas ranged from 900 to 2150 cGy and in normal liver from 80 to 650 cGy. After external-beam irradiation, tumor and normal liver uptake of 90Y antiferritin was consistent with that of 131I antiferritin.

CT volumetrics of primary liver cancers.

A new computer algorithm is described for liver and tumor volume determinations for patients with hepatoma and primary hepatic cholangiocarcinoma. The algorithm is based on global histograms of CT numbers of the liver and primary liver cancers. The algorithm includes computer-assisted definition of the liver boundary in each CT slice. Liver and tumor volumes of 10 patients calculated by the histogram method were compared with volumes obtained from CT slices that were manually contoured by experienced observers. A correlation coefficient of 0.995 was determined for these two methods of volume computations. Mean values of the differences in volumes obtained by the two methods were 6.7 and 8.0% for the liver and tumor, respectively. The computer algorithm was tested on CT scans for an additional 46 patients by highlighting regions corresponding to normal liver and tumor tissues in each CT slice and determined to be accurate by experienced observers. The computer software is being used clinically to assess tumor response in a new treatment program for primary liver cancers that includes radiolabeled antibodies.