3:36 PM Abstract No. 85 Pretreatment 99m Tc-mebrofenin hepatobiliary scintigraphy, an adjuvant predictor of post-radioembolization clinical status

To correlate scintigraphic hepatobiliary 99mTc-mebrofenin uptake ratio prior to 90Y-radioembolization (RE) with post-RE clinical status and liver function. A single-center retrospective review was performed of patients with hepatobiliary 99mTc-mebrofenin scan prior to RE for primary or secondary liver malignancy from July 2015 to September 2017. Regions of interest for mebrofenin uptake were drawn over the entire image, heart and liver. Corrected mebrofenin uptake ratio (cMUR) was calculated as%uptake/min/BSA (body surface area). Pre-RE and 2-month post-RE albumin, total bilirubin, ECOG, MELD, ALBI, and Child-Pugh (CP) scores were compared using Wilcoxon rank sum test for continuous variables and Fisher’s exact test for categorical variables. Pre-RE cMUR was correlated with the 2-month post-RE measures of liver function using the Spearman’s rank correlation test. Significance was considered at p<0.05. Results are presented as median and interquartile range. Twenty-two patients were included. Eleven (50%) patients had hepatocellular carcinoma, the remaining metastatic disease. 6 (30%) patients had cirrhosis. Pre-RE cMUR was 6.32%uptake/min/m2 (5.04-8.33). Total delivered activity and dose were 36.87 mCi (17.11-46.29) and 53.82 Gy (34.82-81.63), respectively. At 2-month follow-up, albumin decrease (3.1 vs. 3.55g/dL, p = 0.03), CP (6.5 vs. 6, p = 0.028) and ALBI scores (-1.79 vs. -2.375, p = 0.009) worsening from pre-RE values were the only statistically significant changes. Pre-RE cMUR demonstrated significant negative correlation with post-RE CP (p = 0.0091) and ALBI scores (p = 0.0365). Total delivered activity and dose showed no significant correlation. Pre-RE cMUR was an effective predictor of post-RE CP and ALBI scores, suggesting possible use of cMUR as a surrogate marker for selecting ideal RE candidates. The results may have been limited by sample size, however, this study provides preliminary evidence to support further exploration of this relationship in future studies.