Role of nanoparticles in transarterial radioembolization with glass microspheres

Objective Transarterial Radioembolization (TARE) with 90 Y-loaded glass microspheres is a locoregional treatment option for Hepatocellular Carcinoma (HCC). Post-treatment 90 Y bremsstrahlung imaging using Single-Photon Emission Tomography (SPECT) is currently a gold-standard imaging modality for quantifying the delivered dose. However, the nature of bremsstrahlung photons causes difficulty for dose estimation using SPECT imaging. This work aimed to investigate the possibility of using glass microspheres loaded with 90 Y and Nanoparticles (NPs) to improve the quantification of delivered doses. Methods The Monte Carlo codes were used to simulate the post-TARE 90 Y planar imaging. Planar images from bremsstrahlung photons and characteristic X-rays are acquired when 0, 1.2 mol/L, 2.4 mol/L, and 4.8 mol/L of Gold (Au), Hafnium (Hf), and Gadolinium (Gd) NPs are incorporated into the glass microspheres. We evaluated the quality of acquired images by calculating sensitivity and Signal-to-Background Ratio (SBR). Therapeutic effects of NPs were evaluated by calculation of Dose Enhancement Ratio (DER) in tumoral and non-tumoral liver tissues. Results The in silico results showed that the sensitivity values of bremsstrahlung and characteristic X-ray planar images increased significantly as the NPs concentration increased in the glass microspheres. The SBR values decreased as the NPs concentration increased for the bremsstrahlung planar images. In contrast, the SBR values increased for the characteristic X-ray planar images when Hf and Gd were incorporated into the glass microspheres. The DER values decreased in the tumoral and non-tumoral liver tissues as the NPs concentration increased. The maximum dose reduction was observed at the NPs concentration of 4.8 mol/L (≈ 7%). Conclusions The incorporation of Au, Hf, and Gd NPs into the glass microspheres improved the quality and quantity of post-TARE planar images. Also, treatment efficiency was decreased significantly at NPs concentration > 4.8 mol/L.