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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 patient after liver-directed radioembolisation using (90)Y glass microspheres, to quantitatively estimate occupational dose of medical personnel providing patient care to the radioembolised patient with the use of the method, to discuss radiation exposure to adjacent patients if the radioembolised patient needs hospitalisation. METHOD: A lead lined blanket of lead equivalence of 0...
December 20, 2016: 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
PURPOSE: (90)Y microsphere, selective internal radiation therapy (SIRT) is a valuable treatment in unresectable hepatocellular carcinoma (HCC). Partition-model predictive dosimetry relies on differential tumoral/non-tumoral perfusion evaluated on pre-treatment (99m)Tc macroaggregate albumin (MAA) single photon emission tomography (SPECT) / computed tomography (CT). The aim of this study was to evaluate the agreement between predictive dosimetry of (99m)Tc-MAA SPECT/CT and post-treatment dosimetry based on (90)Y time-of-flight (TOF) positron emission tomography (PET)/CT...
June 15, 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
Susan J Dutton, Nicola Kenealy, Sharon B Love, Harpreet S Wasan, Ricky A Sharma
BACKGROUND: Colorectal cancer (CRC) is the second most common malignancy in Europe and a leading cause of cancer-related death. Almost 50% of patients with CRC develop liver metastases, which heralds a poor prognosis unless metastases can be downsized to surgical resection or ablation. The FOXFIRE trial examines the hypothesis that combining radiosensitising chemotherapy (OxMdG: oxaliplatin, 5-fluorouracil and folic acid) with Selective Internal Radiation Therapy (SIRT or radioembolisation) using yttrium-90 resin microspheres (SIR-Spheres®; Sirtex Medical Limited, North Sydney, Australia) as a first-line treatment for liver-dominant metastatic CRC will improve clinical outcomes when compared to OxMdG chemotherapy alone...
July 9, 2014: BMC Cancer
Maciej Janusz Powerski, Christian Scheurig-Münkler, Bernd Hamm, Bernhard Gebauer
INTRODUCTION: To evaluate the uptake of the liver-specific magnetic resonance imaging (MRI) contrast agent gadolinium ethoxybenzyl diethylenetriamine pentaacetic acid (Gd-EOB-DTPA) by functional liver parenchyma after radioembolisation (RE) of hepatic malignancies. METHODS: Uptake of Gd-EOB-DTPA prior to RE versus 60+/-24d and 126+/-32d after RE was compared in a group of 33 patients with primary or secondary hepatic malignancies. In patients who underwent single-lobe treatment, left and right lobes were compared 59+/-24 days after RE...
August 2014: Journal of Medical Imaging and Radiation Oncology
Fabian Morsbach, Bert-Ram Sah, Lea Spring, Gilbert Puippe, Sonja Gordic, Burkhardt Seifert, Niklaus Schaefer, Thomas Pfammatter, Hatem Alkadhi, Caecilia S Reiner
OBJECTIVE: To determine the best predictor for the response to and survival with transarterial radioembolisation (RE) with (90)yttrium microspheres in patients with liver metastases. METHODS: Forty consecutive patients with liver metastases undergoing RE were evaluated with multiphase CT, perfusion CT and (99m)Tc-MAA SPECT. Arterial perfusion (AP) from perfusion CT, HU values from the arterial (aHU) and portal venous phase (pvHU) CT, and (99m)Tc-MAA uptake ratio of metastases were determined...
July 2014: European Radiology
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