Emilie Roncali, Ph.D.

By  Holly Ober

DAVIS, Calif. October 5, 2017  Emilie Roncali, an Assistant Project Scientist in the Cherry Lab, has received an Institutional Research Grant Pilot Funding from the UC Davis Comprehensive Cancer Center to investigate the effectiveness of combined radioemobolization therapy and PET imaging for liver cancer.

Liver cancer is one of the leading causes of death worldwide, with a growing incidence and mortality rate. Radioembolization, in which microspheres loaded with radioactive yttrium 90 (Y-90) block the artery feeding the tumor and deliver a strong dose of radiation directly into the tumor, is increasingly used to treat advanced liver cancer.

Unfortunately, the Y-90 microspheres are difficult to image, and this treatment is only used in patients who have advanced cancer, with limited decrease in the cancer’s progression and survival of only around 1 year.

“The role of imaging post radioembolization is crucial to improve long term patient outcome by rapidly identifying the tumors that did not receive a sufficient dose, and might continue to grow undetected,” says Roncali.

With improvement, this treatment could be used on all liver tumors and has the potential to change long term patient care.

Positron emission tomography (PET) after radioembolization is a very promising approach to assess the dose delivered by the treatment, and is being rapidly adopted as a routine exam by most European centers as well as large US hospitals where radioembolization is performed. No additional radioactive tracer is injected to the patient, so the only radiation the patient receives is the therapeutic Y90.

Roncali was awarded this pilot grant to conduct a pilot study using Y-90 PET in 10 liver cancer patients shortly after radioembolization. After radioembolization treatment by collaborator Dr. Catherine Vu, Chief of Interventional Radiology at the UC Davis Medical Center, the patients will be scanned with one of the latest generation time-of-flight PET scanners in Nuclear Medicine at the UC Davis Medical Center.

UC Davis is uniquely positioned to make a breakthrough in Y-90 PET, with the arrival of the total-body, ultra-high sensitivity PET scanner EXPLORER in 2018. This study will bring a multidisciplinary team of Interventional Radiology and Nuclear Medicine up to speed for Y-90 quantitative PET imaging by implementing all the protocols necessary to compute the absorbed dose from the PET images.

“We expect the ultra-high sensitivity and long axial field-of-view of EXPLORER to provide a significant improvement in image quality and quantification,” says Roncali.