Liver Function Changes After Technetium-99m-Macroaggregated Albumin Administration and Their Predictive Value Regarding Hepatotoxicity in Patients Undergoing Yttrium-90-Radioembolization

Anticancer Res. 2021 Jan;41(1):437-444. doi: 10.21873/anticanres.14793.

Abstract

Background/aim: Intraarterial Technetium-99m-Macroaggregated Albumin (99mTc-MAA) administration is an established method to predict particle distribution prior to radioembolization. This study aimed to analyse the impact of intraarterial administration of 99mTc-MAA on changes in liver-specific laboratory parameters and to assess whether such changes are associated with post-radioembolization hepatotoxicity.

Patients and methods: A total of 202 patients treated with radioembolization received prior mapping angiography with 99mTc-MAA administration. All patients underwent clinical and laboratory examinations, including liver-specific parameters at certain times before and after mapping angiography/99mTc-MAA administration, as well as before radioembolization and during follow-up.

Results: Bilirubin increased temporarily after 99mTc-MAA administration (p<0.001), but was not clinically relevant, and returned close to the initial value before radioembolization. These changes showed no association with subsequent postradioembolic hepatotoxicity or shortened overall survival.

Conclusion: 99mTc-MAA administration results in a significant, however, not clinically relevant transient increase in bilirubin levels, which does not provide a predictive value for subsequent radioembolization outcome or postradioembolic hepatotoxicity.

Keywords: 99mTc-MAA; Technetium-99m-Macroaggregated Albumin; hepatotoxicity; radioembolization.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Chemical and Drug Induced Liver Injury / diagnosis*
  • Chemical and Drug Induced Liver Injury / etiology*
  • Computed Tomography Angiography
  • Disease Management
  • Embolization, Therapeutic / adverse effects*
  • Embolization, Therapeutic / methods
  • Female
  • Humans
  • Liver Function Tests
  • Liver Neoplasms / complications*
  • Liver Neoplasms / therapy*
  • Male
  • Middle Aged
  • Prognosis
  • Radiopharmaceuticals / administration & dosage
  • Radiopharmaceuticals / adverse effects*
  • Retrospective Studies
  • Technetium Tc 99m Aggregated Albumin / administration & dosage
  • Technetium Tc 99m Aggregated Albumin / adverse effects*
  • Treatment Outcome

Substances

  • Radiopharmaceuticals
  • Technetium Tc 99m Aggregated Albumin