Safety and Efficacy of Y-90 Radioembolization After Prior Major Hepatic Resection
- RWTH Aachen University Hospital, Department of Diagnostic and Interventional Radiology (Germany)
- RWTH Aachen University Hospital, Department of General Surgery (Germany)
- RWTH Aachen University Hospital, Department of Nuclear Medicine (Germany)
PurposeTo evaluate the safety and efficacy of yttrium-90 radioembolization (RE) following left or right hepatic lobectomy.Materials and MethodsBetween 2011 and 2016, 15 patients underwent RE with Y90-resin microspheres following right (8/15) or left (7/15) hepatic lobectomy. In eight patients, the whole liver remnant was treated during a single session, whereas the remaining seven patients received up to 3 selective RE at 1- to 2-month intervals. The administered patient activity was calculated based on the body surface area (BSA) method in all cases. In addition, CT-based volumetry of the liver remnant was performed and used to calculate the absorbed liver dose. Patient follow-up data were retrospectively analyzed regarding signs of radioembolization-induced liver disease (REILD), defined as occurrence of bilirubin >3.0 mg/dl and ascites within 1–2 months after treatment without tumor progression or bile duct occlusion.ResultsThe mean volume of the liver remnant was 1.471 ± 341 ml, the mean administered amount of activity amounted to 1.31 ± 0.74 GBq, and the calculated mean absorbed dose was 42.8 ± 20.6 Gy. The early response to treatment was generally positive, with only one patient showing signs of progressive disease of the treated area on follow-up examinations within the first 2 months post-RE. None of the 15 patients developed a REILD.ConclusionY-90 radioembolization following extended hepatic lobectomy appears to be safe and effective. Although the standard BSA-based dosing seems to suffice to avoid REILD, it results in quite variable liver doses due to variable hypertrophy of the liver remnant post-hepatectomy. Level of Evidence: Level IV, Case series.
- OSTI ID:
- 22756472
- Journal Information:
- Cardiovascular and Interventional Radiology, Vol. 40, Issue 8; Other Information: Copyright (c) 2017 Springer Science+Business Media, LLC and the Cardiovascular and Interventional Radiological Society of Europe (CIRSE); Article Copyright (c) 2017 Springer Science+Business Media New York and the Cardiovascular and Interventional Radiological Society of Europe (CIRSE); http://www.springer-ny.com; Country of input: International Atomic Energy Agency (IAEA); ISSN 0174-1551
- Country of Publication:
- United States
- Language:
- English
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