Radioembolization with Y-90 Glass Microspheres: Do We Really Need SPECT-CT to Identify Extrahepatic Shunts?

PloS One
J M TheysohnT C Lauenstein

Abstract

Selective Internal Radiation Therapy (SIRT) with 90yttrium (Y-90) is an increasingly used therapeutic option for unresectable liver malignancies. Nontarget embolization of extrahepatic tissue secondary to vascular shunting can lead to SIRT associated complications. Our aim was to assess whether extrahepatic shunts can reliably be diagnosed based on hepatic digital subtraction angiography (DSA) or whether subsequent SPECT/CT data can provide additional information. 825 patients with hepatocellular carcinoma (n = 636), hepatic metastases (n = 158) or cholangiocellular carcinoma (n = 31) were retrospectively analyzed. During hepatic DSA 128 arteries causing shunt flow to gastrointestinal tissue were coilembolized (right gastric artery n = 63, gastroduodenal artery n = 29; branches to duodenum / pancreas n = 36). Technectium-99m-labeled human serum albumin (HSA) was injected in all 825 patients. SPECT/CT data was used to identify additional or remaining shunts to extrahepatic tissue. An unexpected uptake of HSA in extrahepatic tissue was found by SPECT/CT in 54/825 (6.5%) patients (located in stomach n = 13, duodenum n = 26, distal bowel segments n = 12, kidney n = 1, diaphragm n = 2). These patients underwent repeated DSA and newl...Continue Reading

References

Oct 15, 2008·The American Journal of Surgical Pathology·Clinton D CrowderKenneth P Batts
Apr 18, 2009·Journal of Nuclear Medicine : Official Publication, Society of Nuclear Medicine·Monia E HamamiGerald Antoch
Feb 26, 2010·RöFo : Fortschritte auf dem Gebiete der Röntgenstrahlen und der Nuklearmedizin·T A HeusnerG Antoch
Jul 28, 2010·Journal of Nuclear Medicine : Official Publication, Society of Nuclear Medicine·Hojjat AhmadzadehfarSamer Ezziddin
May 14, 2011·Cardiovascular and Interventional Radiology·P M PaprottkaR T Hoffmann
Dec 23, 2011·Radiology·Riccardo Lencioni, Laura Crocetti
Aug 9, 2012·International Journal of Radiation Oncology, Biology, Physics·Naichang YuAllan Wilkinson
Sep 18, 2012·Cardiovascular and Interventional Radiology·Jens M TheysohnThomas C Lauenstein
Feb 26, 2013·Cardiovascular and Interventional Radiology·Marnix G E H LamDaniel Y Sze
May 25, 2013·World Journal of Gastroenterology : WJG·Iago Rodríguez-LagoBruno Sangro
Dec 18, 2013·Journal of Vascular and Interventional Radiology : JVIR·Vanessa L GatesRiad Salem
Jan 21, 2014·European Journal of Nuclear Medicine and Molecular Imaging·Hojjat AhmadzadehfarMartha Hoffmann
Feb 12, 2014·Journal of Nuclear Medicine : Official Publication, Society of Nuclear Medicine·Alina ZarvaHolger Amthauer
Aug 15, 2014·Frontiers in Oncology·Ahsun RiazRiad Salem
Aug 27, 2014·Journal of Vascular and Interventional Radiology : JVIR·Andrew C GordonRobert J Lewandowski

❮ Previous
Next ❯

Citations

Aug 11, 2018·Acta chirurgica Belgica·Edward WillemsMathieu D'Hondt
Sep 30, 2020·Physics in Medicine and Biology·Lucrezia AuditoreSilvano Gnesin
Nov 28, 2020·Physics in Medicine and Biology·Lucrezia AuditoreSilvano Gnesin
Nov 7, 2020·Journal of Cancer Research and Clinical Oncology·Max MasthoffMoritz Wildgruber
Jan 27, 2018·Journal of Nuclear Medicine : Official Publication, Society of Nuclear Medicine·Helmut DittmannChristian la Fougère

❮ Previous
Next ❯

Methods Mentioned

BETA
imaging techniques

Software Mentioned

[UNK]

Related Concepts

Related Feeds

Carcinoma, Hepatocellular

Hepatocellular Carcinoma is a malignant cancer in liver epithelial cells. Discover the latest research on Hepatocellular Carcinoma here.

Cajal Bodies & Gems

Cajal bodies or coiled bodies are dense foci of coilin protein. Gemini of Cajal bodies, or gems, are microscopically similar to Cajal bodies. It is believed that Cajal bodies play important roles in RNA processing while gems assist the Cajal bodies. Find the latest research on Cajal bodies and gems here.