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Semra İnce, Bülent Karaman, Engin Alagoz, Nuri Karadurmuş, Hüseyin Şan, Cemal Nuri Erçin, Nuri Arslan
BACKGROUND/AIM: Selective intraarterial radionuclide therapy (SIRT) with yttrium-90 (Y-90) resin microspheres presently has successful results in primary or metastatic inoperable liver tumors. This procedure, which is also known as radioembolisation, delivers high doses of radiation selectively to hepatic tumors while minimum healthy liver exposure. The aim of this study was to present our clinical experience of radiomicrosphere therapy for the treatment of patients with unresectable hepatocellular carcinoma (HCC)...
June 20, 2017: Journal of Gastrointestinal Cancer
Kathy P Willowson, Aimee R Hayes, David L H Chan, Michael Tapner, Elizabeth J Bernard, Richard Maher, Nick Pavlakis, Stephen J Clarke, Dale L Bailey
BACKGROUND: The aim of this study was to investigate the relationship between absorbed dose and response of colorectal cancer liver metastases treated with [(90)Y]-resin microspheres and to explore possible clinical and imaging derived prognostic factors. METHODS: FDG PET/CT was used to measure response of individual lesions to a measured absorbed dose, derived from post-treatment (90)Y PET imaging. Predicted dose was also derived from planning [(99m)Tc]-MAA SPECT data...
December 2017: EJNMMI Research
Bruno Sangro, Diego Martínez-Urbistondo, Lourens Bester, Jose I Bilbao, Douglas M Coldwell, Patrick Flamen, Andrew Kennedy, Jens Ricke, Ricky A Sharma
Selective internal radiation therapy (SIRT or radioembolisation) by intraarterial injection of radioactive yttrium-90 ((90) Y)-loaded microspheres is increasingly used for the treatment of patients with liver metastases or primary liver cancer. The high-dose beta-radiation penetrates an average of only 2.5 mm from the source so that its effects are limited to the site of delivery. However the off-target diversion of (90) Y microspheres to tissues other than the tumor may lead to complications. The most prominent ones include: radiation gastritis and gastrointestinal (GI) ulcers, cholecystitis, radiation pneumonitis, and radioembolisation-induced liver disease (REILD)...
April 13, 2017: Hepatology: Official Journal of the American Association for the Study of Liver Diseases
Val Gebski, Emma Gibbs, Mihir Gandhi, Gilles Chatellier, Aurelia Dinut, Helena Pereira, Pierce Kh Chow, Valérie Vilgrain
BACKGROUND: Untreated advanced hepatocellular carcinoma (HCC) has an overall poor prognosis. Currently there are 2 ongoing prospective randomized controlled trials that are evaluating the efficacy and safety of sorafenib and selective internal radiation therapy (SIRT) with yttrium-90 resin microspheres in patients with advanced HCC. The SorAfenib versus Radioembolisation in Advanced Hepatocellular carcinoma (SARAH; 459 patients) trial is being performed in Europe and the SIRt VErsus SorafeNIB (SIRveNIB; 360 patients) trial in the Asia Pacific region...
February 15, 2017: JMIR Research Protocols
Martin Law, K K Wong, W K Tso, Victor Lee, M Y Luk, C C Tong, Ferdinand Chu
OBJECTIVE: To describe a method to reduce the external radiation exposure emitted from the patient after liver-directed radioembolization using (90)Y glass microspheres, to quantitatively estimate the occupational dose of medical personnel providing patient care to the patient radioembolized with the use of the method and to discuss radiation exposure to patients who are adjacent if the patient radioembolized needs hospitalization. METHODS: A lead-lined blanket of lead equivalence of 0...
March 2017: British Journal of Radiology
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
Silvano Gnesin, Laurent Canetti, Salim Adib, Nicolas Cherbuin, Marina Silva Monteiro, Pierre Bize, Alban Denys, John O Prior, Sebastien Baechler, Ariane Boubaker
(90)Y-microsphere selective internal radiation therapy (SIRT) is a valuable treatment in unresectable hepatocellular carcinoma (HCC). Partition-model predictive dosimetry relies on differential tumor-to-nontumor perfusion evaluated on pretreatment (99m)Tc-macroaggregated albumin (MAA) SPECT/CT. The aim of this study was to evaluate agreement between the predictive dosimetry of (99m)Tc-MAA SPECT/CT and posttreatment dosimetry based on (90)Y time-of-flight (TOF) PET/CT. METHODS: We compared the (99m)Tc-MAA SPECT/CT results for 27 treatment sessions (25 HCC patients, 41 tumors) with (90)Y SIRT (7 glass spheres, 20 resin spheres) and the posttreatment (90)Y TOF PET/CT results...
November 2016: Journal of Nuclear Medicine: Official Publication, Society of Nuclear Medicine
Andor F van den Hoven, Manon N G J A Braat, Jip F Prince, Pieter J van Doormaal, Maarten S van Leeuwen, Marnix G E H Lam, Maurice A A J van den Bosch
OBJECTIVES: To compare right gastric (RGA) and segment 4 artery (A4) origin detection rates during radioembolisation workup between early and late arterial phase liver CT protocols. METHODS: 100 consecutive patients who underwent liver CT between May 2012-January 2015 with early or late arterial phase protocol (n = 50 each, 10- vs. 20-s post-threshold delay) were included. RGA/A4 origin detection rates, assessed by two raters, and contrast-to-noise ratio (CNR) of the hepatic artery relative to the portal vein were compared between the protocols...
January 2017: European Radiology
Yung Hsiang Kao, Meir Lichtenstein
No abstract text is available yet for this article.
June 2016: Journal of Medical Imaging and Radiation Oncology
Omar M Abdel-Rahman, Zeinab Elsayed
BACKGROUND: Hepatocellular carcinoma is the most common liver neoplasm and the fifth most common cancer worldwide. Moreover, its incidence has increased dramatically since the mid-2000s. While surgical resection and liver transplantation are the main curative treatments, only around 20% of people with early hepatocellular carcinoma may benefit from these therapies. Current treatment options for unresectable hepatocellular carcinoma include various ablative and trans-arterial therapies in addition to the drug sorafenib...
2016: Cochrane Database of Systematic Reviews
V Urbain, P Meunier, B Otto
We report the case of a young man with a juvenile nasopharyngeal angiofibroma. In this paper, we will first remind the clinical signs of this pathology and its radiological appearance (localisation and extensions). Then we will explain how radioembolisation techniques were used to facilitate the surgical intervention. Finally we will discuss the histology of this tumor.
September 2015: Revue Médicale de Liège
Xingshun Qi, Xiaozhong Guo
Sorafenib is the first-line treatment of choice for advanced hepatocellular carcinoma (HCC). However, the benefits of sorafenib in HCC patients with portal vein tumour thrombosis (PVTT) remain uncertain. Until now, a total of eight comparative studies have been identified for this systematic review. Four retrospective studies showed that hepatic arterial infusion chemotherapy, hepatic resection, and three-dimensional conformal radiotherapy might be superior to sorafenib in improving the overall survival. Two ongoing randomised controlled trials (RCTs) will compare the outcomes of transarterial chemoembolisation or radioembolisation with those of sorafenib for the treatment of HCC with PVTT...
2015: Przegla̜d Gastroenterologiczny
Fikri Bouazza, Arthur Poncelet, Camilo Alejandro Garcia, Philippe Delatte, Jean Luc Engelhom, Maria Gomez Galdon, Amélie Deleporte, Alain Hendlisz, Bruno Vanderlinden, Patrick Flamen, Vincent Donckier
Resectability of hepatocellular carcinoma in patients with chronic liver disease is dramatically limited by the need to preserve sufficient remnant liver in order to avoid postoperative liver insufficiency. Preoperative treatments aimed at downsizing the tumor and promoting hypertrophy of the future remnant liver may improve resectability and reduce operative morbidity. Here we report the case of a patient with a large hepatocellular carcinoma arising from chronic liver disease. Preoperative treatment, including tumor downsizing with transarterial radioembolization and induction of future remnant liver hypertrophy with right portal vein embolization, resulted in a 53% reduction in tumor volume and compensatory hypertrophy in the contralateral liver...
August 28, 2015: World Journal of Gastroenterology: WJG
Yung Hsiang Kao, Mark Goodwin, Sze Ting Lee, Meir Lichtenstein, Andrew Mark Scott
Today's tomographic imaging techniques such as catheter-directed CT and single photon emission computed tomography with integrated computed tomography may be used for pre-therapy radiation planning for radioembolisation based on prospective calculation of tissue radiation absorbed doses. We outline the scientific concepts that underlie modern personalised tomographic radiation planning for radioembolisation and highlight its similarities to brachytherapy planning.
October 2015: Journal of Medical Imaging and Radiation Oncology
Jonas Högberg, Magnus Rizell, Ragnar Hultborn, Johanna Svensson, Olof Henrikson, Johan Mölne, Peter Gjertsson, Peter Bernhardt
BACKGROUND: Selective arterial radioembolisation of liver tumours has increased, because of encouraging efficacy reports; however, therapeutic parameters used in external beam therapy are not applicable for understanding and predicting potential toxicity and efficacy, necessitating further studies of the physical and biological characteristics of radioembolisation. The aim was to characterise heterogeneity in the distribution of microspheres on a therapeutically relevant geometric scale considering the range of yttrium-90 ((90)Y) β-particles...
December 2014: EJNMMI Research
Rita Golfieri, Cristina Mosconi, Emanuela Giampalma, Alberta Cappelli, Maria Cristina Galaverni, Cinzia Pettinato, Matteo Renzulli, Fabio Monari, Renzo Mazzarotto, Carmine Pinto, Bruna Angelelli
PURPOSE: The target lesion response (according to the Choi criteria), safety and survival following selective or superselective transarterial radioembolisation using yttrium-90-resin microspheres ((90)Y-RE) were evaluated in patients with unresectable, chemotherapy-refractory colorectal cancer liver metastases (mCRC). MATERIALS AND METHODS: A prospective case series evaluated 52 consecutive patients with mCRC who were treated at a single centre following a median of 2 lines of chemotherapy...
August 2015: La Radiologia Medica
Peter Gibbs, Val Gebski, Mark Van Buskirk, Kenneth Thurston, David N Cade, Guy A Van Hazel
BACKGROUND: In colorectal cancer (CRC), unresectable liver metastases are linked to poor prognosis. Systemic chemotherapy with regimens such as FOLFOX (combination of infusional 5-fluorouracil, leucovorin and oxaliplatin) is the standard first-line treatment. The SIRFLOX trial was designed to assess the efficacy and safety of combining FOLFOX-based chemotherapy with Selective Internal Radiation Therapy (SIRT or radioembolisation) using yttrium-90 resin microspheres (SIR-SpheresR; Sirtex Medical Limited, North Sydney, Australia)...
December 1, 2014: BMC Cancer
Valérie Vilgrain, Mohamed Abdel-Rehim, Annie Sibert, Maxime Ronot, Rachida Lebtahi, Laurent Castéra, Gilles Chatellier
BACKGROUND: Untreated advanced hepatocellular carcinoma (HCC) is linked to poor prognosis. While sorafenib is the current recommended treatment for advanced HCC, radioembolisation (RE; also called selective internal radiation therapy or SIRT) with yttrium-90 microspheres has shown efficacy in cohort studies. However, there are no head-to-head trials comparing radiation therapy with yttrium-90 microspheres and sorafenib in advanced HCC. The SARAH trial has been designed to compare the efficacy and safety of sorafenib therapy and RE using yttrium-90 resin microspheres (SIR-Spheres™; Sirtex Medical Limited, North Sydney, Australia) in patients with advanced HCC...
December 3, 2014: Trials
A Lopez, N Noiret, E Garin, N Lepareur
Yttrium-90 is a radioelement which has found wide use in targeted radionuclide therapy because of its attractive physical and chemical properties. Radioembolisation of hepatocellular carcinoma with radiolabelled Lipiodol is a method of choice. We have synthesised a series of alkyldithiocarbamate yttrium complexes, easily extracted into Lipiodol due to their high lipophilicity. Among the prepared series, a new radioconjugate, which is stable over an extended period of time, has been prepared, and could represent a potential treatment procedure for hepatocellular carcinoma...
December 2014: Applied Radiation and Isotopes
Manuel Sanchez-Garcia, Isabelle Gardin, Rachida Lebtahi, Arnaud Dieudonné
To speed-up the absorbed dose (AD) computation while accounting for tissue heterogeneities, a Collapsed Cone (CC) superposition algorithm was developed and validated for (90)Y. The superposition was implemented with an Energy Deposition Kernel scaled with the radiological distance, along with CC acceleration. The validation relative to Monte Carlo simulations was performed on 6 phantoms involving soft tissue, lung and bone, a radioembolisation treatment and a simulated bone metastasis treatment. As a figure of merit, the relative AD difference (ΔAD) in low gradient regions (LGR), distance to agreement (DTA) in high gradient regions and the γ(1%,1 mm) criterion were used for the phantoms...
September 7, 2014: Physics in Medicine and Biology
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