Internal radiation therapy for patients with primary or metastatic hepatic cancer

Ho, Stephen; Lau, W. Y.; Leung, Thomas W.T.; Johnson, Philip J.

doi:10.1002/(sici)1097-0142(19981101)83:9<1894::aid-cncr4>3.0.co;2-o

Cited by 108 publications

(25 citation statements)

References 65 publications

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“…TARE aims to provide a tumoricidal dose of around 100 Gy to the hepatic tumor while keeping the exposure of normal hepatocytes to a minimum; preferably below 40–60 Gy [ 40 , 41 ] . In patients with multifocal tumors for whom selective injection is not possible and when the tumor/normal liver ratio is low, higher doses of radiation energy may get delivered to non-tumorous liver.…”

Section: Benign Post-treatment Findingsmentioning

confidence: 99%

Yttrium-90 radioembolization of liver tumors: what do the images tell us?

Singh¹,

Anil²

2013

Cancer Imaging

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Transarterial radioembolization (TARE) with yttrium 90 microspheres is an increasingly popular therapy for both primary and secondary liver malignancies. TARE entails delivery of β-particle brachytherapy and embolization of the tumor vasculature. The consequent biological sequelae are distinct from those of other transarterial therapies for liver tumors, as reflected in the often baffling post-treatment imaging features. As the clinical use of TARE is increasing, more diverse post-treatment radiological findings are encountered with variable overlap among treatment response, residual disease, reactionary changes and complications. Thus, post-TARE image interpretation is challenging. This review provides a comprehensive description of the different findings seen in post-treatment scans, with the aim of facilitating appropriate radiological interpretation of post-TARE pathologic changes, notwithstanding their existing limitations.

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Section: Benign Post-treatment Findingsmentioning

confidence: 99%

Yttrium-90 radioembolization of liver tumors: what do the images tell us?

Singh¹,

Anil²

2013

Cancer Imaging

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“…Subsequently, nuclear imaging is performed to determine whether extrahepatic deposition of the 90 Y-MS should be expected and to calculate the lung-shunt fraction [5–7]. The images are also used to predict the intrahepatic distribution of the 90 Y-MS or, more specifically, the tumour-to-normal tissue ratio [8–10]. The 99m Tc-MAA are thus deployed as full surrogates for the 90 Y-MS.…”

Section: Introductionmentioning

confidence: 99%

Holmium-166 poly(L-lactic acid) microsphere radioembolisation of the liver: technical aspects studied in a large animal model

et al. 2009

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ObjectiveTo assess the accuracy of a scout dose of holmium-166 poly(L-lactic acid) microspheres (166Ho-PLLA-MS) in predicting the distribution of a treatment dose of 166Ho-PLLA-MS, using single photon emission tomography (SPECT).MethodsA scout dose (60 mg) was injected into the hepatic artery of five pigs and SPECT acquired. Subsequently, a ‘treatment dose’ was administered (540 mg) and SPECT, computed tomography (CT) and magnetic resonance imaging (MRI) of the total dose performed. The two SPECT images of each animal were compared. To validate quantitative SPECT an ex vivo liver was instilled with 166Ho-PLLA-MS and SPECT acquired. The liver was cut into slices and planar images were acquired, which were registered to the SPECT image.ResultsQualitatively, the scout dose and total dose images were similar, except in one animal because of catheter displacement. Quantitative analysis, feasible in two animals, tended to confirm this similarity (r2 = 0.34); in the other animal the relation was significantly better (r2 = 0.66). The relation between the SPECT and planar images acquired from the ex vivo liver was strong (r2 = 0.90).ConclusionIn the porcine model a scout dose of 166Ho-PLLA-MS can accurately predict the biodistribution of a treatment dose. Quantitative 166Ho SPECT was validated for clinical application.

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“…Radioactive yttrium‐90 resin microspheres have been used to treat non‐resectable malignant primary 1,2 or secondary liver tumors 3 by intra‐arterial embolization of the spheres into the precapillary tumor circulation to deliver high dose selective internal radiotherapy. We report a case of an embolization procedure complicated by the development of radiation‐induced gastric ulceration caused by extrahepatic microsphere deposition.…”

mentioning

confidence: 99%