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Vivian L Bishay, Derek M Biederman, Thomas J Ward, Imramsjah Martijn J van der Bom, Rahul S Patel, Edward Kim, Francis S Nowakowski, Robert A Lookstein, Aaron M Fischman
OBJECTIVE: The transradial approach (TRA) has been shown to reduce the morbidity and mortality associated with arterial coronary interventions. Selective internal radiation therapy (SIRT) performed via the TRA can enhance patient comfort, compared with the traditional transfemoral approach (TFA), by allowing immediate ambulation and precluding potential complications associated with the TFA, such as closure device injury or retroperitoneal hematoma. We report our initial experience with and technique for using the TRA for SIRT...
November 2016: AJR. American Journal of Roentgenology
Jorge Aramburu, Raúl Antón, Alejandro Rivas, Juan Carlos Ramos, Bruno Sangro, José Ignacio Bilbao
Radioembolization, which consist of the implantation of radioactive microspheres via intra-arterially placed microcatheter, is a safe and effective treatment for liver cancer. Nevertheless, radioembolization-related complications and side effects may arise, which are an active area of ongoing research. The catheter design has been claimed as an option in reducing these complications. In this paper, the influence of catheter type and location are investigated. The study was undertaken by numerically simulating the particle-hemodynamics in a patient-specific hepatic artery during liver radioembolization...
October 7, 2016: Journal of Biomechanics
Jorge Aramburu, Raúl Antón, Alejandro Rivas, Juan Carlos Ramos, Bruno Sangro, José Ignacio Bilbao
Liver radioembolization is a treatment option for patients with primary and secondary liver cancer. The procedure consists of injecting radiation-emitting microspheres via an intra-arterially placed microcatheter, enabling the deposition of the microspheres in the tumoral bed. The microcatheter location and the particle injection rate are determined during a pretreatment work-up. The purpose of this study was to numerically study the effects of the injection characteristics during the first stage of microsphere travel through the bloodstream in a patient-specific hepatic artery (i...
October 5, 2016: Journal of Biomechanics
Chadwick L Wright, Jun Zhang, Katherine Binzel, Evan J Wuthrick, Michael V Knopp
Imaging of Y internal pair production with conventional photomultiplier detector PET technology has been previously reported for patients with malignant/metastatic liver lesions treated with Y radioembolization (RE). We present a 54-year-old man with unresectable liver metastases from rectal carcinoma (involving the right and left lobes) who was referred for Y RE and subsequently imaged using new solid-state digital photon counting technology (Vereos 64 Time-of-Flight PET/CT; Philips, Cleveland, OH). Despite imaging at 26 hours following RE, digital PET/CT provides improved image quality and Y-to-background contrast as well as accurate visualization of Y biodistribution when compared with Bremsstrahlung SPECT/CT...
October 5, 2016: Clinical Nuclear Medicine
Brandon Cramer, Minzhi Xing, Hyun S Kim
PURPOSE: To determine the effect of Y radioembolization therapy on health-related quality of life (HRQOL) in patients with neuroendocrine tumor liver metastases (NETLM) in a prospective longitudinal study. MATERIALS AND METHODS: Baseline Short-Form 36 HRQOL scores were evaluated for significant change (P < 0.05) within the total patient population at 1, 3, 6, 12, and 24 months following Y using paired t-test. Overall survival (OS) times were calculated from first Y using the Kaplan-Meier method and analyzed using the log-rank test...
October 5, 2016: Clinical Nuclear Medicine
Zhongzhi Jia, Guomin Jiang, Feng Tian, Chunfu Zhu, Xihu Qin
BACKGROUND/AIM: Over the past two decades, several advances have been made in the management of patients with hepatocellular carcinoma (HCC) and portal vein tumor thrombosis (PVTT). Yttrium-90 ( 90 Y) radioembolization has recently been made a treatment option for patients with HCC and PVTT. However, there is still a need to systematicly evaluate the outcomes of 90 Y radioembolization for HCC and PVTT. We aimed to assess the safety and effectiveness of 90 Y radioembolization for HCC and PVTT...
September 2016: Saudi Journal of Gastroenterology: Official Journal of the Saudi Gastroenterology Association
Suresh Subramanian, Usha Pandey, Pradip Chaudhari, Monica Tyagi, Sanjay Gupta, Geetanjali Singh, Ashutosh Dash, Grace Samuel, Meera Venkatesh
BACKGROUND & OBJECTIVES: Yttrium-90 ( 90 Y)-based radioembolization has been employed to treat hepatocellular carcinoma (HCC) as commercial radioactive glass and polymeric resin microspheres. However, in India and other Asian countries, these preparations must be imported and are expensive, validating the need for development of indigenous alternatives. This work was aimed to develop an economically and logistically favourable indigenous alternative to imported radioembolizing agents for HCC therapy...
May 2016: Indian Journal of Medical Research
Suresh de Silva, Simon Mackie, Peter Aslan, David Cade, Warick Delprado
BACKGROUND: Intra-arterial brachytherapy with yttrium-90 ((90)Y) resin microspheres (radioembolization) is a procedure to selectively deliver high-dose radiation to tumors. The purpose of this research was to compare the radioembolic effect of (90)Y-radioembolization versus the embolic effect of bland microspheres in the porcine kidney model. METHODS: In each of six pigs, ~25-33 % of the kidney volume was embolized with (90)Y resin microspheres and an equivalent number of bland microspheres in the contralateral kidney...
October 14, 2016: Cardiovascular and Interventional Radiology
James X Chen, Steven Rose, Sarah B White, Ghassan El-Haddad, Nicholas Fidelman, Hooman Yarmohammadi, Winifred Hwang, Daniel Y Sze, Nishita Kothary, Kristen Stashek, E Paul Wileyto, Riad Salem, David C Metz, Michael C Soulen
PURPOSE: The purpose of the study was to evaluate prognostic factors for survival outcomes following embolotherapy for neuroendocrine tumor (NET) liver metastases. MATERIALS AND METHODS: This was a multicenter retrospective study of 155 patients (60 years mean age, 57 % male) with NET liver metastases from pancreas (n = 71), gut (n = 68), lung (n = 8), or other/unknown (n = 8) primary sites treated with conventional transarterial chemoembolization (TACE, n = 50), transarterial radioembolization (TARE, n = 64), or transarterial embolization (TAE, n = 41) between 2004 and 2015...
October 13, 2016: Cardiovascular and Interventional Radiology
Benjamin Sueur, Olivier Pellerin, Thibault Voron, Anne L Pointet, Julien Taieb, Simon Pernot
The objective of the treatment of colorectal cancer patients with unresectable liver metastases should be clearly defined at the outset. Potentially resectable patients should be distinguished from clearly unresectable patients. In defining resectability, it is important to take into account both anatomic characteristics and patient characteristic (comorbidities, symptoms, age). According to this evaluation, treatment should be tailored to each patient. The most widely accepted standard is doublet cytotoxic regimen plus biotherapy (anti-EGFR or anti- VEGF antibodies according to RAS status, but some patients could benefit from an intensified regimen, as triplet chemotherapy +/- bevacizumab, or intraarterial treatments (hepatic arterial infusion, radioembolization or chemoembolization), in order to allow resectability...
October 12, 2016: Minerva Chirurgica
Michel Rayar, Giovanni Battista Levi Sandri, Pauline Houssel-Debry, Christophe Camus, Laurent Sulpice, Karim Boudjema
Treatment of intrahepatic cholangiocarcinoma remains a major challenge. For an unresectable lesion without extrahepatic spread, liver transplantation could be a potential solution but it is still associated with poor oncologic results owing to the absence of effective neoadjuvant treatment. We report the case of a young man with locally advanced intrahepatic cholangiocarcinoma presenting with multiple intrahepatic metastases and vascular structure involvement. The lesion was significantly downstaged by a multimodal therapy including intra-arterial Yttrium-90 radioembolization, systemic chemotherapy and external radiotherapy, allowing liver transplantation...
September 2016: Journal of Gastrointestinal and Liver Diseases: JGLD
B Gui, A A Weiner, J L Nosher, S E Lu, P J Parikh, S K Jabbour
No abstract text is available yet for this article.
October 1, 2016: International Journal of Radiation Oncology, Biology, Physics
H Mohammadi, Y A Abuodeh, W Jin, J M Frakes, M Friedman, B Biebel, J Choi, G E El-Haddad, B Kis, J Sweeney, R Kim, J M Pimiento, M P Malafa, D Anaya, S E Hoffe
No abstract text is available yet for this article.
October 1, 2016: International Journal of Radiation Oncology, Biology, Physics
H M McGee, M King, A Olson, E Kim, A Fischman, M Schwartz, K Rosenzweig, M Buckstein
No abstract text is available yet for this article.
October 1, 2016: International Journal of Radiation Oncology, Biology, Physics
P Ioannides, Y A Abuodeh, W Jin, S E Hoffe, J M Frakes, R Kim, J Choi, G El-Hadda, B Biebel, B Kis, J Sweeney, M Friedman, N Kothari, D Anaya, K Latifi
No abstract text is available yet for this article.
October 1, 2016: International Journal of Radiation Oncology, Biology, Physics
Tetsuhide Ito, Lingaku Lee, Robert T Jensen
INTRODUCTION: Neuroendocrine tumors(NETs), once thought rare, are increasing in frequency in most countries and receiving increasing-attention. NETs present two-treatment problems. A proportion is aggressive and a proportion has a functional, hormone-excess-state(F-NET) each of which, must be treated. Recently, there have been many advances, well-covered in reviews/consensus papers on imaging-NETs; new, novel anti-tumor treatments and understanding their pathogenesis. However, little attention has been paid to advances in the treatment of the hormone-excess-state...
September 16, 2016: Expert Opinion on Pharmacotherapy
Jens Altenbernd, Axel Wetter, Michael Forsting, Lale Umutlu
PURPOSE: The aim of this prospective study was to examine the diagnostic value of dual-energy CT (DECT) in the assessment of response of HCC after radioembolisation (RE). MATERIAL AND METHODS: 40 HCC patients with 82 measurable target lesions were included in this study. At baseline and follow-up examination target lesions were evaluated with (IU), AASLD and Choi measurement criteria. Disease control was defined as the sum of complete response (CR), partial response (PR), progression disease (PD) and stable disease (SD)...
2016: European Journal of Radiology Open
Bin Cai, Michael B Altman, Jose Garcia-Ramirez, Jason LaBrash, S Murty Goddu, Sasa Mutic, Parag J Parikh, Jeffrey R Olsen, Nael Saad, Jacqueline E Zoberi
PURPOSE: To develop a safe and robust workflow for yttrium-90 (Y-90) radioembolization procedures in a multidisciplinary team environment. METHODS AND MATERIALS: A generalized Define-Measure-Analyze-Improve-Control (DMAIC)-based approach to process improvement was applied to a Y-90 radioembolization workflow. In the first DMAIC cycle, events with the Y-90 workflow were defined and analyzed. To improve the workflow, a web-based interactive electronic white board (EWB) system was adopted as the central communication platform and information processing hub...
September 8, 2016: Brachytherapy
Emine Acar, Gamze Çapa Kaya, Hatice Durak
A 72-year-old man was diagnosed with well-differentiated neuroendocrine tumor of unknown primary with liver metastasis. All liver lesions were detectable only on Ga-DOTATATE PET/CT and were negative on F-FDG PET/CT. Intrahepatic Y radioembolization therapy was planned, but the hepatopulmonary shunt fraction was found to be 31.6%. Because the hepatopulmonary shunt fraction greater than 20% is an absolute contraindication to radioembolization, we decided to give him Lu-DOTATATE therapy. He received 4 courses of Lu-DOTATATE and showed regression in posttherapy Ga-DOTATATE PET/CT imaging...
November 2016: Clinical Nuclear Medicine
Rahul Mehta, Kejia Cai, Nishant Kumar, M Grace Knuttinen, Thomas M Anderson, Hui Lu, Yang Lu
We present a probabilistic approach to identify patients with primary and secondary hepatic malignancies as responders or nonresponders to yttrium-90 radioembolization therapy. Recent advances in computer-aided detection have decreased false-negative and false-positive rates of perceived abnormalities; however, there is limited research in using similar concepts to predict treatment response. Our approach is driven by the goal of precision medicine to determine pretherapy fluorine-18-2-fluoro-2-deoxy-d-glucose positron emission tomography and computed tomography imaging parameters to facilitate the identification of patients who would benefit most from yttrium-90 radioembolization therapy, while avoiding complex and costly procedures for those who would not...
September 6, 2016: Technology in Cancer Research & Treatment
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