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Purpose <p>To evaluate the histopathologic effects of resin Yttrium-90 Transarterial Radioembolization (<sup>90</sup>Y-TARE) on intrahepatic cholangiocarcinoma (iCCA), and correlate dose with outcomes.</p> Materials and methods <p>This retrospective, single-center study included adult patients with iCCA treated with <sup>90</sup>Y-TARE using resin microspheres. Histopathologic and dosimetry results were evaluated. Imaging response was assessed. Complete pathologic necrosis (CPN) was defined as 100% tumor necrosis, and extensive necrosis as &gt; 90% necrosis. Treatment factors affecting the pathologic necrosis rate were evaluated.</p> Results <p>For 18 patients, the median age was 69 years [IQR, 67–71 years], with 56% male, and median tumor size of 6.4&#xa0;cm [IQR,5.1–8.2&#xa0;cm]. Surgical resection was performed 127 [IQR, 100–182] days after <sup>90</sup>Y-TARE. CPN was achieved in 4/18 (22%) patients, with extensive necrosis in 13/18 (72%) patients. Extensive necrosis rate was higher in patients with a prescribed dose <i>≥</i> 180&#xa0;Gy (10/11 [91%]), compared to patients with a prescribed dose &lt; 180&#xa0;Gy (3/7 [43%], <i>p</i> = 0.03). Patients treated with <sup>90</sup>Y-TARE as a first line treatment had higher odds of achieving extensive necrosis compared to patients who received <sup>90</sup>Y-TARE after chemotherapy (OR = 11, <i>p</i> = 0.047). All lesions classified as complete response by mRECIST at the 3-month evaluation exhibited extensive necrosis, corresponding to a sensitivity of 58% and a positive predictive value (PPV) of 100%.</p> Conclusion <p><sup>90</sup>Y-TARE with resin microspheres is associated with a CPN rate of 22% and extensive necrosis rate of 72% in iCCA, with a prescribed dose of <i>≥</i> 180&#xa0;Gy predicting extensive necrosis.</p>

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Histopathologic analysis of intrahepatic cholangiocarcinoma treated with transarterial radioembolization using Yttrium-90 resin microspheres

  • 期刊论文

  • 发表日期：

    2025年11月11日

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  • Muhammad Mohid Tahir,
  • Imad A. Nasser,
  • Mahmoud Odeh,
  • Aamir Ali,
  • Katja N. De Paepe,
  • Charissa Kim,
  • Safija Nizamic,
  • Diana Dinh,
  • Jeffrey L. Weinstein,
  • Anuradha S. Shenoy-Bhangle,
  • Andrea Bullock,
  • Martin Dib,
  • Devin Eckhoff,
  • Muneeb Ahmed,
  • Ammar Sarwar

摘要

Purpose

To evaluate the histopathologic effects of resin Yttrium-90 Transarterial Radioembolization (90Y-TARE) on intrahepatic cholangiocarcinoma (iCCA), and correlate dose with outcomes.

Materials and methods

This retrospective, single-center study included adult patients with iCCA treated with 90Y-TARE using resin microspheres. Histopathologic and dosimetry results were evaluated. Imaging response was assessed. Complete pathologic necrosis (CPN) was defined as 100% tumor necrosis, and extensive necrosis as > 90% necrosis. Treatment factors affecting the pathologic necrosis rate were evaluated.

Results

For 18 patients, the median age was 69 years [IQR, 67–71 years], with 56% male, and median tumor size of 6.4 cm [IQR,5.1–8.2 cm]. Surgical resection was performed 127 [IQR, 100–182] days after 90Y-TARE. CPN was achieved in 4/18 (22%) patients, with extensive necrosis in 13/18 (72%) patients. Extensive necrosis rate was higher in patients with a prescribed dose ≥ 180 Gy (10/11 [91%]), compared to patients with a prescribed dose < 180 Gy (3/7 [43%], p = 0.03). Patients treated with 90Y-TARE as a first line treatment had higher odds of achieving extensive necrosis compared to patients who received 90Y-TARE after chemotherapy (OR = 11, p = 0.047). All lesions classified as complete response by mRECIST at the 3-month evaluation exhibited extensive necrosis, corresponding to a sensitivity of 58% and a positive predictive value (PPV) of 100%.

Conclusion

90Y-TARE with resin microspheres is associated with a CPN rate of 22% and extensive necrosis rate of 72% in iCCA, with a prescribed dose of ≥ 180 Gy predicting extensive necrosis.