Case Report: Radioactive Holmium-166 Microspheres for the Intratumoral Treatment of a Canine Pituitary Tumor

Introduction: In this case study, a client-owned dog with a large pituitary tumor was experimentally treated by intratumoral injection of radioactive holmium-166 microspheres (166HoMS), named 166Ho microbrachytherapy. To our knowledge, this is the first intracranial intratumoral treatment through ne...

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Autores principales:	Nino Chiron Morsink, Nienke Johanna Maria Klaassen, Björn Petrus Meij, Jolle Kirpensteijn, Guillaume Cornelis Maria Grinwis, Irene Afra Schaafsma, Jan Willem Hesselink, Johannes Frank Wilhelmus Nijsen, Sebastiaan Alexander van Nimwegen
Formato:	article
Lenguaje:	EN
Publicado:	Frontiers Media S.A. 2021
Materias:	brachytherapy canine dog holmium intratumoral treatment pituitary Veterinary medicine SF600-1100
Acceso en línea:	https://doaj.org/article/5939f528311a48159689fbff6002a44f
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spelling	oai:doaj.org-article:5939f528311a48159689fbff6002a44f2021-11-04T08:53:20ZCase Report: Radioactive Holmium-166 Microspheres for the Intratumoral Treatment of a Canine Pituitary Tumor2297-176910.3389/fvets.2021.748247https://doaj.org/article/5939f528311a48159689fbff6002a44f2021-11-01T00:00:00Zhttps://www.frontiersin.org/articles/10.3389/fvets.2021.748247/fullhttps://doaj.org/toc/2297-1769Introduction: In this case study, a client-owned dog with a large pituitary tumor was experimentally treated by intratumoral injection of radioactive holmium-166 microspheres (166HoMS), named 166Ho microbrachytherapy. To our knowledge, this is the first intracranial intratumoral treatment through needle injection of radioactive microspheres.Materials and Methods: A 10-year-old Jack Russell Terrier was referred to the Clinic for Companion Animal Health (Faculty of Veterinary Medicine, Utrecht University, The Netherlands) with behavioral changes, restlessness, stiff gait, and compulsive circling. MRI and CT showed a pituitary tumor with basisphenoid bone invasion and marked mass effect. The tumor measured 8.8 cm3 with a pituitary height-to-brain area (P/B) ratio of 1.86 cm−1 [pituitary height (cm) ×10/brain area (cm2)]. To reduce tumor volume and neurological signs, 166HoMS were administered in the tumor center by transsphenoidal CT-guided needle injections.Results: Two manual CT-guided injections were performed containing 0.6 ml of 166HoMS suspension in total. A total of 1097 MBq was delivered, resulting in a calculated average tumor dose of 1866 Gy. At 138 days after treatment, the tumor volume measured 5.3 cm3 with a P/B ratio of 1.41 cm−1, revealing a total tumor volume reduction of 40%. Debulking surgery was performed five months after 166HoMS treatment due to recurrent neurological signs. The patient was euthanized two weeks later at request of the owners. Histopathological analysis indicated a pituitary adenoma at time of treatment, with more malignant characteristics during debulking surgery.Conclusion: The 40% tumor volume reduction without evident severe periprocedural side effects demonstrated the feasibility of intracranial intratumoral 166HoMS treatment in this single dog.Nino Chiron MorsinkNienke Johanna Maria KlaassenBjörn Petrus MeijJolle KirpensteijnGuillaume Cornelis Maria GrinwisIrene Afra SchaafsmaJan Willem HesselinkJohannes Frank Wilhelmus NijsenJohannes Frank Wilhelmus NijsenSebastiaan Alexander van NimwegenFrontiers Media S.A.articlebrachytherapycaninedogholmiumintratumoral treatmentpituitaryVeterinary medicineSF600-1100ENFrontiers in Veterinary Science, Vol 8 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	brachytherapy canine dog holmium intratumoral treatment pituitary Veterinary medicine SF600-1100
spellingShingle	brachytherapy canine dog holmium intratumoral treatment pituitary Veterinary medicine SF600-1100 Nino Chiron Morsink Nienke Johanna Maria Klaassen Björn Petrus Meij Jolle Kirpensteijn Guillaume Cornelis Maria Grinwis Irene Afra Schaafsma Jan Willem Hesselink Johannes Frank Wilhelmus Nijsen Johannes Frank Wilhelmus Nijsen Sebastiaan Alexander van Nimwegen Case Report: Radioactive Holmium-166 Microspheres for the Intratumoral Treatment of a Canine Pituitary Tumor
description	Introduction: In this case study, a client-owned dog with a large pituitary tumor was experimentally treated by intratumoral injection of radioactive holmium-166 microspheres (166HoMS), named 166Ho microbrachytherapy. To our knowledge, this is the first intracranial intratumoral treatment through needle injection of radioactive microspheres.Materials and Methods: A 10-year-old Jack Russell Terrier was referred to the Clinic for Companion Animal Health (Faculty of Veterinary Medicine, Utrecht University, The Netherlands) with behavioral changes, restlessness, stiff gait, and compulsive circling. MRI and CT showed a pituitary tumor with basisphenoid bone invasion and marked mass effect. The tumor measured 8.8 cm3 with a pituitary height-to-brain area (P/B) ratio of 1.86 cm−1 [pituitary height (cm) ×10/brain area (cm2)]. To reduce tumor volume and neurological signs, 166HoMS were administered in the tumor center by transsphenoidal CT-guided needle injections.Results: Two manual CT-guided injections were performed containing 0.6 ml of 166HoMS suspension in total. A total of 1097 MBq was delivered, resulting in a calculated average tumor dose of 1866 Gy. At 138 days after treatment, the tumor volume measured 5.3 cm3 with a P/B ratio of 1.41 cm−1, revealing a total tumor volume reduction of 40%. Debulking surgery was performed five months after 166HoMS treatment due to recurrent neurological signs. The patient was euthanized two weeks later at request of the owners. Histopathological analysis indicated a pituitary adenoma at time of treatment, with more malignant characteristics during debulking surgery.Conclusion: The 40% tumor volume reduction without evident severe periprocedural side effects demonstrated the feasibility of intracranial intratumoral 166HoMS treatment in this single dog.
format	article
author	Nino Chiron Morsink Nienke Johanna Maria Klaassen Björn Petrus Meij Jolle Kirpensteijn Guillaume Cornelis Maria Grinwis Irene Afra Schaafsma Jan Willem Hesselink Johannes Frank Wilhelmus Nijsen Johannes Frank Wilhelmus Nijsen Sebastiaan Alexander van Nimwegen
author_facet	Nino Chiron Morsink Nienke Johanna Maria Klaassen Björn Petrus Meij Jolle Kirpensteijn Guillaume Cornelis Maria Grinwis Irene Afra Schaafsma Jan Willem Hesselink Johannes Frank Wilhelmus Nijsen Johannes Frank Wilhelmus Nijsen Sebastiaan Alexander van Nimwegen
author_sort	Nino Chiron Morsink
title	Case Report: Radioactive Holmium-166 Microspheres for the Intratumoral Treatment of a Canine Pituitary Tumor
title_short	Case Report: Radioactive Holmium-166 Microspheres for the Intratumoral Treatment of a Canine Pituitary Tumor
title_full	Case Report: Radioactive Holmium-166 Microspheres for the Intratumoral Treatment of a Canine Pituitary Tumor
title_fullStr	Case Report: Radioactive Holmium-166 Microspheres for the Intratumoral Treatment of a Canine Pituitary Tumor
title_full_unstemmed	Case Report: Radioactive Holmium-166 Microspheres for the Intratumoral Treatment of a Canine Pituitary Tumor
title_sort	case report: radioactive holmium-166 microspheres for the intratumoral treatment of a canine pituitary tumor
publisher	Frontiers Media S.A.
publishDate	2021
url	https://doaj.org/article/5939f528311a48159689fbff6002a44f
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Case Report: Radioactive Holmium-166 Microspheres for the Intratumoral Treatment of a Canine Pituitary Tumor

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