Innovative intravaskuläre Tumortherapie mittels Holmium-166

In der Welt der selektiven internen Radiotherapie (kurz: SIRT) dominierte bisher das Isotop Yttrium-90 (⁹⁰Y). Seit 2015 ist mit Holmium-166 (¹⁶⁶Ho) eine Alternative erhältlich, welches sich in unserem Institut neben ⁹⁰Y etabliert hat. In diesem Artikel werden wir die Vor- und Nachteile der beiden Isotope beleuchten und einen klinischen Fall aus der Perspektive der Nuklearmedizin näher beschreiben.

Abstract

The selective internal radiotherapy (SIRT) is a minimally invasive procedure to treat hepatic malignancies. For a long time, the isotope ⁹⁰Y has been the primary choice for radioembolization. Beginning in 2015, ¹⁶⁶Ho microspheres have become available and can be used for diagnostic and therapeutic purposes. They are ready-to-use products with short preparation and handling times. Most of the preparations, such as connecting the tubes and flushing them with saline, are done without the nuclide present. With specialized dosimetry software, estimation of the mean absorbed dose of lung, healthy liver, and tumor tissue is possible, making it feasible to plan more treatment sessions if necessary. The ¹⁶⁶Ho microspheres have excellent physical characteristics for use with SPECT, such as a primary gamma peak of 81 keV. Due to the paramagnetic properties of ¹⁶⁶Ho and the stable daughter nuclide ¹⁶⁶Er, MRI imaging is also possible. The spheres are made of PLLA with a diameter of 15–60 µm. ¹⁶⁶Ho has a half-life of 26,8 h, requiring the injection of a higher activity compared to ⁹⁰Y. Apart from a short stay at the day clinic, it is possible to perform the therapy on an outpatient basis.

Schlüsselwörter

SIRT - 166Ho-Mikrosphären - Radionuklidtherapie - hepatozelluläres Karzinom - interventionelle Radiologie

Key word

SIRT - 166Ho microspheres - radionuclide therapy - hepatocellular carcinoma - interventional radiology

Publication History

Article published online:
28 November 2023

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