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SIR-Spheres Microspheres

Francesca Botta, Mahila Ferrari, Carlo Chiesa, Sara Vitali, Francesco Guerriero, Maria Chiara De Nile, Marta Mira, Leda Lorenzon, Massimiliano Pacilio, Marta Cremonesi
PURPOSE: To investigate the clinical implication of performing pre-treatment dosimetry for 90 Y-microspheres liver radioembolization on 99m Tc-MAA SPECT images reconstructed without attenuation or scatter correction and quantified with the patient relative calibration methodology. METHODS: Twenty-five patients treated with SIR-Spheres® at Istituto Europeo di Oncologia and 31 patients treated with TheraSphere® at Istituto Nazionale Tumori were considered. For each acquired 99m Tc-MAA SPECT, four reconstructions were performed: with attenuation and scatter correction (AC_SC), only attenuation (AC_NoSC), only scatter (NoAC_SC) and without corrections (NoAC_NoSC)...
April 2018: Medical Physics
Luca Filippi, Orazio Schillaci, Roberto Cianni, Oreste Bagni
Intrahepatic cholangiocarcinoma (ICC) is a severe and rapidly progressive hepatic tumor. Surgery is often impracticable due to locally advanced presentation. On the other hand, chemotherapy has demonstrated only limited effectiveness. For these reasons, liver-directed therapies have been successfully applied for treating ICC. In particular, radioembolization with Yttrium-90 (90 Y)-labeled spheres has been reported to be a promising therapeutic approach for this neoplasia. Two commercial forms of90 Y-labeled spheres are available: glass (TheraSphere® ) and resin (SIR-Spheres® ) microspheres...
December 18, 2017: Future Oncology
Pierce Kh Chow, Mihir Gandhi, Val Gebski
No abstract text is available yet for this article.
October 2017: Future Oncology
May Cho, Jonathan Kessler, John J Park, Aram Lee, Jun Gong, Gagandeep Singh, Yi-Jen Chen, Philip H G Ituarte, Marwan Fakih
BACKGROUND: The use of selective internal radiation therapy with yttrium 90 resin microspheres (SIR-Spheres®) in chemotherapy-resistant colorectal cancer liver metastases has been associated with favorable progression-free survival (PFS) and overall survival when given alone or concurrently with chemotherapy. We conducted a single institute retrospective trial to explore the potential impact of SIR-Spheres® with concurrent chemotherapy vs. SIR-Spheres® alone on liver PFS in patients with colorectal liver metastases (CRLM)...
August 2017: Journal of Gastrointestinal Oncology
Eric A Wang, Jeff P Stein, Ross J Bellavia, Scott R Broadwell
Hepatocellular carcinoma (HCC), the predominant form of primary liver cancer, is the second leading cause of cancer-related deaths across the globe. Only a small percentage of HCC patients (~20%-30%) are diagnosed at an early stage when first-line treatment options may be effective. The majority of HCC patients (>70%) are diagnosed with unresectable disease and given a poor overall prognosis. Current treatment guidelines recommend locoregional therapy with transarterial chemoembolisation (TACE) and systemic therapy with sorafenib as first-line treatment for patients with intermediate and advanced stage HCC...
July 30, 2017: International Journal of Clinical Practice
Fernando Pardo, Bruno Sangro, Rheun-Chuan Lee, Derek Manas, Rohan Jeyarajah, Vincent Donckier, Geert Maleux, Antonio D Pinna, Lourens Bester, David L Morris, David Iannitti, Pierce K Chow, Richard Stubbs, Paul J Gow, Gianluca Masi, Kevin T Fisher, Wan Y Lau, Konstantinos Kouladouros, Georgios Katsanos, Giorgio Ercolani, Fernando Rotellar, José I Bilbao, Michael Schoen
BACKGROUND: Reports show that selective internal radiation therapy (SIRT) may downsize inoperable liver tumors to resection or transplantation, or enable a bridge-to-transplant. A small-cohort study found that long-term survival in patients undergoing resection following SIRT appears possible but no robust studies on postsurgical safety outcomes exist. The Post-SIR-Spheres Surgery Study was an international, multicenter, retrospective study to assess safety outcomes of liver resection or transplantation following SIRT with yttrium-90 (Y-90) resin microspheres (SIR-Spheres®; Sirtex)...
September 2017: Annals of Surgical Oncology
Eric A Wang, Scott R Broadwell, Ross J Bellavia, Jeff P Stein
Hepatocellular carcinoma (HCC) and intrahepatic cholangiocarcinoma (ICC) often present at stages where patients have limited treatment options. Use of selective internal radiation therapy (SIRT) with yttrium-90 (Y-90) resin microspheres has progressed as data increasingly speak to its utility in patients with both intermediate and late stage disease in these cancers. In anticipation of the pending completion of several prospective randomized controlled multicenter studies exploring the use of Y-90 resin microspheres in primary liver cancers, this article outlines mechanisms involved in SIRT administration and reviews key efficacy and safety data that are currently available in the literature involving use of this therapy in both HCC and ICC...
April 2017: Journal of Gastrointestinal Oncology
Pradeep S Virdee, Joanna Moschandreas, Val Gebski, Sharon B Love, E Anne Francis, Harpreet S Wasan, Guy van Hazel, Peter Gibbs, Ricky A Sharma
BACKGROUND: In colorectal cancer (CRC), unresectable liver metastases are associated with a poor prognosis. The FOXFIRE (an open-label randomized phase III trial of 5-fluorouracil, oxaliplatin, and folinic acid +/- interventional radioembolization as first-line treatment for patients with unresectable liver-only or liver-predominant metastatic colorectal cancer), SIRFLOX (randomized comparative study of FOLFOX6m plus SIR-Spheres microspheres versus FOLFOX6m alone as first-line treatment in patients with nonresectable liver metastases from primary colorectal carcinoma), and FOXFIRE-Global (assessment of overall survival of FOLFOX6m plus SIR-Spheres microspheres versus FOLFOX6m alone as first-line treatment in patients with nonresectable liver metastases from primary colorectal carcinoma in a randomized clinical study) clinical trials were designed to evaluate the efficacy and safety of combining first-line chemotherapy with selective internal radiation therapy (SIRT) using yttrium-90 resin microspheres, also called transarterial radioembolization...
March 28, 2017: JMIR Research Protocols
Joseph Ralph Kallini, Ahmed Gabr, Kristian Thorlund, Chakrapani Balijepalli, Dieter Ayres, Steve Kanters, Shanil Ebrahim, Edward Mills, Robert J Lewandowski, Riad Salem
To compare the safety profiles of TheraSphere® (glass) and SIR-Spheres® (resin) Y90 microspheres for the treatment of hepatocellular carcinoma. A systematic review was conducted using the databases MEDLINE, Embase, and Cochrane Trials Register to identify all relevant studies. Baseline characteristics and adverse events of all grades related to gastrointestinal, hepatobiliary, and respiratory systems were collected along with commonly reported outcomes related to post-embolization syndrome. For all outcomes, data from each study were tabulated for each intervention...
July 2017: Cardiovascular and Interventional Radiology
Cherng Chao, S William Stavropoulos, Jeffrey I Mondschein, Mandeep Dagli, Deepak Sudheendra, Gregory Nadolski, Michael C Soulen
PURPOSE: The objective of this study was to evaluate the effect of substituting 50% Isovue (Bracco Diagnostics Inc, Monroe Township, NJ) for sterile water on the delivery of Y resin microspheres (SIR-Spheres [Sirtex Medical Limited, Sydney, Australia]). MATERIALS AND METHODS: The authors retrospectively reviewed all SIR-Spheres radioembolizations at the authors' institution from January 1, 2011, to February 10, 2014. From January 1, 2011, to April 30, 2013, all users performed SIR-Spheres radioembolization per the manufacturer's original instructions using sterile water in the B and D lines and intermittently checking the progress of the embolization by injecting contrast via the B line...
March 2017: Clinical Nuclear Medicine
Elena Gallio, Elisa Richetta, Monica Finessi, Michele Stasi, Riccardo Emanuele Pellerito, Gianni Bisi, Roberto Ropolo
PURPOSE: Radioembolization with 90Y microspheres is an effective treatment for unresectable liver tumours. Two types of microspheres are available: resin (SIR-Spheres®) and glass (Theraspheres®). The aim of this study is to compare biological effective dose (BED) values obtained with three different dosimetric methods. METHODS: 29 HCC patients were included in this study: 15 were treated with resin(mean injected activity 1.5GBq, range 0.8-2.7GBq) and 14 with glass microspheres (2...
December 2016: Physica Medica: PM
Mihir Gandhi, Su Pin Choo, Choon Hua Thng, Say Beng Tan, Albert Su Chong Low, Peng Chung Cheow, Anthony Soon Whatt Goh, Kiang Hiong Tay, Richard Hoau Gong Lo, Brian Kim Poh Goh, Jen San Wong, David Chee Eng Ng, Khee Chee Soo, Wei Ming Liew, Pierce K H Chow
BACKGROUND: Approximately 20 % of hepatocellular carcinoma (HCC) patients diagnosed in the early stages may benefit from potentially curative ablative therapies such as surgical resection, transplantation or radiofrequency ablation. For patients not eligible for such options, prognosis is poor. Sorafenib and Selective Internal Radiation Therapy (SIRT) are clinically proven treatment options in patients with unresectable HCC, and this study aims to assess overall survival following either SIRT or Sorafenib therapy for locally advanced HCC patients...
November 7, 2016: BMC Cancer
Edward Wolfgang Lee, Lourdes Alanis, Sung-Ki Cho, Sammy Saab
Hepatocellular carcinoma is the most common primary liver cancer and it represents the majority of cancer-related deaths in the world. More than 70% of patients present at an advanced stage, beyond potentially curative options. Ytrrium-90 selective internal radiation therapy (Y90-SIRT) with glass microspheres is rapidly gaining acceptance as a potential therapy for intermediate and advanced stage primary hepatocellular carcinoma and liver metastases. The technique involves delivery of Y90 infused glass microspheres via the hepatic arterial blood flow to the appropriate tumor...
July 2016: Korean Journal of Radiology: Official Journal of the Korean Radiological Society
Kelly Cooper Younge, Choonik Lee, Jean M Moran, Mary Feng, Paula Novelli, Joann I Prisciandaro
PURPOSE: We performed a failure mode and effects analysis (FMEA) during the addition of a new microspheres product into our existing microsphere brachytherapy program to identify areas for safety improvements. METHODS AND MATERIALS: A diverse group of team members from the microsphere program participated in the project to create a process map, identify and score failure modes, and discuss programmatic changes to address the highest ranking items. We developed custom severity ranking scales for staff- and institution-related failure modes to encompass possible risks that may exist outside of patient-based effects...
November 2016: Practical Radiation Oncology
Kelley M Ferreira, Andrew J Fenwick, Arzu Arinc, Lena C Johansson
The use of (90)Y resin microspheres (SIR-Spheres® microspheres) in Nuclear Medicine has dramatically increased in recent years due to its favourable outcome in the treatment of liver cancer and liver metastases (Rajekar et al., 2011). The measurement of administered activity before and residual activity after treatment in radionuclide calibrators is required to determine total activity delivered to the patient. In comparison with External Beam Radiotherapy (EBRT) where administered doses are often know to within ±5%, the actual administered activity in nuclear medicine procedures may only be known to within ±20% and subsequent dose calculations can result in even larger uncertainties (Fenwick et al...
March 2016: Applied Radiation and Isotopes
C Thiam, C Bobin, V Lourenço, V Chisté, M-N Amiot, X Mougeot, D Lacour, F Rigoulay, L Ferreux
The present paper addresses the calibration of well-type ionization chambers (ICs) used at LNE-LNHB as standard transfer instruments to calibrate hospitals in the case of SIR-Spheres(®)(90)Y resin microspheres (Sirtex, Australia). Developed for interventional oncology, this radiopharmaceutical is directly injected in the liver for cancer treatment via a selective internal radiation therapy. The present work was carried out in the framework of the European project "Metrology for molecular radiotherapy" (MetroMRT)...
March 2016: Applied Radiation and Isotopes
Harun Ilhan, Anna Goritschan, Philipp Paprottka, Tobias F Jakobs, Wolfgang P Fendler, Andrei Todica, Peter Bartenstein, Marcus Hacker, Alexander R Haug
UNLABELLED: This study analyzed the predictive value of (99m)Tc-labeled macroaggregated albumin ((99m)Tc-MAA) SPECT for (90)Y-labeled resin microsphere therapy (radioembolization) by comparing uptake on pretherapeutic (99m)Tc-MAA SPECT with uptake on posttherapeutic (90)Y-bremsstrahlung SPECT. METHODS: We included 502 patients (55% male; mean age ± SD, 62 ± 11 y) who underwent radioembolization between 2005 and 2013 because of primary or secondary liver malignancies (colorectal cancer [n = 195, 38...
November 2015: Journal of Nuclear Medicine: Official Publication, Society of Nuclear Medicine
Thomas Carlier, Kathy P Willowson, Eugene Fourkal, Dale L Bailey, Mohan Doss, Maurizio Conti
PURPOSE: (90)Y -positron emission tomography (PET) imaging is becoming a recognized modality for postinfusion quantitative assessment following radioembolization therapy. However, the extremely low counts and high random fraction associated with (90)Y -PET may significantly impair both qualitative and quantitative results. The aim of this work was to study image quality and noise level in relation to the quantification and bias performance of two types of Siemens PET scanners when imaging (90)Y and to compare experimental results with clinical data from two types of commercially available (90)Y microspheres...
July 2015: Medical Physics
K C Younge, C I Lee, M Feng, P Novelli, J M Moran, J I Prisciandaro
PURPOSE: To improve the safety and quality of a dual-vendor microsphere brachytherapy program with failure mode and effects analysis (FMEA). METHODS: A multidisciplinary team including physicists, dosimetrists, a radiation oncologist, an interventional radiologist, and radiation safety personnel performed an FMEA for our dual-vendor microsphere brachytherapy program employing SIR-Spheres (Sirtex Medical Limited, Australia) and Theraspheres (BTG, England). We developed a program process tree and step-by-step instructions which were used to generate a comprehensive list of failure modes...
June 2015: Medical Physics
L Kroger
UNLABELLED: The role of the Radiation Safety Officer at a medical facility can be complicated. The complexity of the position is based on the breadth of services provided at the institution and the nature of the radioactive materials license. Medical practices are constantly changing and the use of ionizing radiation continues to rise in this area. Some of the newer medical applications involving radiation have unique regulatory and safety issues that must be addressed. Oversight of the uses of radiation start at the local level (radiation safety officer, radiation safety committee) and are heavily impacted by outside agencies (i...
June 2015: Medical Physics
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