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Updated: May 13, 2025
Ultrasound-Guided Orthotopic Implantation of Murine Pancreatic Ductal Adenocarcinoma
Published on: November 19, 2019
Intratumoral Holmium-166 Microsphere Injection in Patients with Unresectable Pancreatic Ductal Adenocarcinoma: A
C Ysbrand Willink1, Sjoerd F M Jenniskens1, Martijn W J Stommel2
1Department of Medical Imaging, Radboud University Medical Center, Nijmegen, The Netherlands.
Introduction:
Pancreatic ductal adenocarcinoma (PDAC) has a poor prognosis and lacks local treatment options. This study aimed to assess the feasibility and safety of the first-in-human intraoperative ultrasound-guided intratumoral injection of radioactive holmium-166 microsphere in patients with PDAC.
Methods:
Patients with proven PDAC eligible for open surgical resection were included. If resection was abandoned during exploration, study intervention was performed. Feasibility was defined by injection success and on-/off-target radiation. Safety was based on adverse event (AE) monitoring for 12 weeks categorized by severity grade and study attribution.
Results:
Three of the thirteen included patients received study intervention. Injection was successful in all 3 patients. Mean tumor doses of 5.0, 17.0, and 39.0 Gy and maximum tumor doses of 25.0, 41.0 and 256.0 Gy were achieved. Off-target radiation was found once in the lungs and once in the colon with a mean dose <1.0 Gy. There were no AEs with high study attribution, 16, 14, and 19 AEs with low study attribution, including 3, 2, and 4 AEs with grade ≥3. Holmium-166 microspheres appeared hyperdense on CT.
Conclusion:
Intratumoral injection of holmium-166 microspheres in patients with unresectable PDAC seems feasible and safe. Research into minimally invasive image-guided application is advised.
Insights
This study shows that injecting radioactive holmium-166 microspheres into pancreatic ductal adenocarcinoma (PDAC) is feasible and safe. Further research into minimally invasive image-guided applications is recommended for this challenging cancer.
Area of Science:
- Oncology
- Radiology
- Nuclear Medicine
Background:
- Pancreatic ductal adenocarcinoma (PDAC) presents a significant clinical challenge with limited local treatment options and a poor prognosis.
- The study addresses the unmet need for effective local therapies in unresectable PDAC.
Purpose of the Study:
- To evaluate the feasibility and safety of the first-in-human intraoperative ultrasound-guided intratumoral injection of radioactive holmium-166 microspheres in patients with PDAC.
- To assess the efficacy of delivering targeted radiation therapy directly to PDAC tumors.
Main Methods:
- Patients with unresectable PDAC undergoing open surgical exploration were included.
- The intervention involved intraoperative ultrasound-guided intratumoral injection of holmium-166 microspheres if resection was not feasible.
- Feasibility was assessed by injection success and radiation targeting; safety was monitored via adverse events for 12 weeks.
Main Results:
- The study intervention was performed in 3 out of 13 patients, with successful injections in all cases.
- Tumor doses ranged from 5.0 to 39.0 Gy (mean) and 25.0 to 256.0 Gy (maximum).
- Minimal off-target radiation was observed (lungs, colon, <1.0 Gy mean dose); no high-attribution adverse events occurred, with most being low-grade.
Conclusions:
- Intratumoral injection of holmium-166 microspheres appears to be a feasible and safe approach for unresectable PDAC.
- The findings support further investigation into minimally invasive, image-guided applications of this technique for PDAC treatment.
