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Title: Intrahepatic Flow Redistribution in Patients Treated with Radioembolization

IntroductionIn planning Yttrium-90 ({sup 90}Y)-radioembolizations, strategy problems arise in tumours with multiple arterial supplies. We aim to demonstrate that tumours can be treated via one main feeding artery achieving flow redistribution by embolizing accessory vessels.MethodsOne hundred {sup 90}Y-radioembolizations were performed on 90 patients using glass microspheres. In 19 lesions/17 patients, accessory branches were found feeding a minor tumour portion and embolized. In all 17 patients, the assessment of the complete perfusion was obtained by angiography and single photon emission computerized tomography–computerized tomography (SPECT–CT). Dosimetry, toxicity, and tumor response rate of the patients treated after flow redistribution were compared with the 83 standard-treated patients. Seventeen lesions in 15 patients with flow redistribution were chosen as target lesions and evaluated according to mRECIST criteria.ResultsIn all patients, the complete tumor perfusion was assessed immediately before radioembolization by angiography in all patients and after the {sup 90}Y-infusion by SPECT–CT in 15 of 17 patients. In the 15 assessable patients, the response rate in their 17 lesions was 3 CR, 8 PR, and 6 SD. Dosimetric and toxicity data, as well tumour response rate, were comparable with the 83 patients with regular vasculature.ConclusionsAll embolization procedures were performed successfully with no complications, and the flow redistributionmore » was obtained in all cases. Results in term of toxicity, median dose administered, and radiological response were comparable with standard radioembolizations. Our findings confirmed the intratumoral flow redistribution after embolizing the accessory arteries, which makes it possible to treat the tumour through its single main feeding artery.« less
Authors:
;  [1] ;  [2] ;  [3] ; ;  [1] ; ;  [3] ;  [2] ;  [1] ;  [2] ; ;  [1] ;  [3]
  1. Fondazione Istituto Tumori, Department of Radiology (Italy)
  2. Fondazione Istituto Tumori, Department of Nuclear Medicine (Italy)
  3. Fondazione Istituto Tumori, Department of Liver Surgery and Transplant (Italy)
Publication Date:
OSTI Identifier:
22470013
Resource Type:
Journal Article
Resource Relation:
Journal Name: Cardiovascular and Interventional Radiology; Journal Volume: 38; Journal Issue: 2; Conference: BSIR 2014: Britisch Society of Interventional Radiology 2014 annual meeting, Liverpool (United Kingdom), 12-14 Nov 2014; Other Information: Copyright (c) 2015 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)
Country of Publication:
United States
Language:
English
Subject:
62 RADIOLOGY AND NUCLEAR MEDICINE; ARTERIES; BIOMEDICAL RADIOGRAPHY; COMPARATIVE EVALUATIONS; DOSES; DOSIMETRY; FEEDING; INFUSION; MICROSPHERES; NEOPLASMS; PATIENTS; PHOTON EMISSION; PLANNING; RADIOEMBOLIZATION; SINGLE PHOTON EMISSION COMPUTED TOMOGRAPHY; TOXICITY; VASCULAR DISEASES; YTTRIUM 90