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Radioembolización arterial transcatéter

01 febrero 2015

JOURNAL OF VASCULAR AND INTERVENTIONAL RADIOLOGY. Radioembolization in Patients with Progressive Gastrointestinal Stromal Tumor Liver Metastases Undergoing Treatment with Tyrosine Kinase Inhibitors

Nils Rathmann, MD, Steffen J. Diehl, MD , Dietmar Dinter, MD , Jochen Schütte, MD , Daniel Pink, MD , Stefan O. Schoenberg, MD , Peter Hohenberger, MD

Purpose: Gastrointestinal stromal tumors (GISTs) spread frequently to the peritoneum and the liver. If metastasectomy or tyrosine kinase inhibitors (TKIs) fail, interventional ablation techniques are considered. The purpose of this study is to assess the progression-free interval (PFI) of GIST liver metastases after radioembolization (RE).

01 febrero 2015

CARDIOVASCULAR AND INTERVENTIONAL RADIOLOGY. Hepatic Arterial Configuration in Relation to the Segmental Anatomy of the Liver; Observations on MDCT and DSA Relevant to Radioembolization Treatment

Andor F. van den Hoven, Maarten S. van Leeuwen, Marnix G. E. H. Lam, Maurice A. A. J. van den Bosch

Purpose: Current anatomical classifications do not include all variants relevant for radioembolization (RE). The purpose of this study was to assess the individual hepatic arterial configuration and segmental vascularization pattern and to develop an individualized RE treatment strategy based on an extended classification.

01 abril 2014

CARDIOVASCULAR AND INTERVENTIONAL RADIOLOGY. Superiority of Proximal Embolization of the Gastroduodenal Artery with the Amplatzer Vascular Plug 4 Before Yttrium-90 Radioembolization: A Retrospective Comparison with Coils in 134 Patients

Karsten Bulla, Sebastian Hubich, Maciej Pech, David Löwenthal, Jens Ricke, Oliver Dudeck

Purpose: To evaluate the effectiveness of proximal embolization of the gastroduodenal artery (GDA) using the Amplatzer Vascular Plug 4 (AVP 4) compared with pushable coils to avoid hepaticoenteric collaterals of the GDA stump, which may serve as pathways for nontarget embolization.

01 marzo 2014

JOURNAL OF VASCULAR AND INTERVENTIONAL RADIOLOGY. Localized Hyperthermia with Iron Oxide–Doped Yttrium Microparticles: Steps toward Image-Guided Thermoradiotherapy in Liver Cancer

Andrew C. Gordon, BA , Robert J. Lewandowski, MD , Riad Salem, MD, MBA , Delbert E. Day, PhD, MS , Reed A. Omary, MD, MS , Andrew C. Larson, PhD

Purpose: To test whether iron oxide (IO)–containing yttrium aluminosilicate (YAS) microparticles (MPs) can generate localized therapeutic hyperthermia (≥ 43°C) when injected intratumorally in an animal model of liver cancer and whether MP distributions could be visualized with magnetic resonance (MR) imaging.

01 febrero 2014

JOURNAL OF VASCULAR AND INTERVENTIONAL RADIOLOGY. Modified Response Evaluation Criteria in Solid Tumors and European Association for the Study of the Liver Criteria Using Delayed-Phase Imaging at an Early Time Point Predict Survival in Patients with Unresectable Intrahepatic Cholangiocarcinoma following Yttrium-90 Radioembolization

Juan C. Camacho, MD , Nima Kokabi, MD , Minzhi Xing, MD , Hasmukh J. Prajapati, MD , Bassel El-Rayes, MD , Hyun S. Kim, MD

Purpose: To investigate early imaging prognostic factors in unresectable intrahepatic cholangiocarcinoma (ICC) refractory to standard chemotherapy after yttrium-90 (90Y) radioembolization therapy.

01 febrero 2014

JOURNAL OF VASCULAR AND INTERVENTIONAL RADIOLOGY. A Simple Method for Estimating Dose Delivered to Hepatocellular Carcinoma after Yttrium-90 Glass-based Radioembolization Therapy: Preliminary Results of a Proof of Concept Study

Nima Kokabi, MD , James R. Galt, PhD , Minzhi Xing, MD , Juan C. Camacho, MD , Bruce J. Barron, MD , David M. Schuster, MD , Hyun S. Kim, MD

Purpose: To investigate a simple semiquantitative method to estimate yttrium-90 (90Y) dose delivered with radioembolization to infiltrative hepatocellular carcinoma (HCC).

01 febrero 2014

JOURNAL OF VASCULAR AND INTERVENTIONAL RADIOLOGY. Quantitative Dosimetry for Yttrium-90 Radionuclide Therapy: Tumor Dose Predicts Fluorodeoxyglucose Positron Emission Tomography Response in Hepatic Metastatic Melanoma

Bree R. Eaton, MD , Hyun S. Kim, MD , Eduard Schreibmann, PhD , David M. Schuster, MD , James R. Galt, PhD , Bruce Barron, MD , Sungjin Kim, MS , Yuan Liu, PhD , Jerome Landry, MD , Tim Fox, PhD

Purpose: To assess a new method for generating patient-specific volumetric dose calculations and analyze the relationship between tumor dose and positron emission tomography (PET) response after radioembolization of hepatic melanoma metastases.

01 febrero 2014

JOURNAL OF VASCULAR AND INTERVENTIONAL RADIOLOGY. Mistargeting after Fusion Imaging–Guided Percutaneous Radiofrequency Ablation of Hepatocellular Carcinomas

Sanghyeok Lim, MD , Min Woo Lee, MD , Hyunchul Rhim, MD , Dong Ik Cha, MD , Tae Wook Kang, MD , Ji Hye Min, MD , Kyoung Doo Song, MD , Seo-youn Choi, MD , Hyo K. Lim, MD

Purpose: To evaluate the incidence and causes of mistargeting after fusion imaging–guided percutaneous radiofrequency (RF) ablation of hepatocellular carcinomas (HCCs).

01 febrero 2014

JOURNAL OF VASCULAR AND INTERVENTIONAL RADIOLOGY. Pilot Study of Angiogenic Response to Yttrium-90 Radioembolization with Resin Microspheres

Darren R. Carpizo, MD, PhD , Rebekah H. Gensure, BS , Xin Yu, PhD , Vyacheslav M. Gendel, MD , Samuel J. Greene, MD , Dirk F. Moore, PhD , Salma K. Jabbour, MD , John L. Nosher, MD

Purpose: To investigate the impact of radioembolization with yttrium-90 resin microspheres on the regulation of angiogenesis through observation of serial changes in a spectrum of angiogenic markers and other cytokines after therapy.

1 diciembre 2013

WORLD JOURNAL OF GASTROENTEROLOGY. Bridging and downstaging treatments for hepatocellular carcinoma in patients on the waiting list for liver transplantation

Maurizio Pompili, Giampiero Francica, Francesca Romana Ponziani, Roberto Iezzi and Alfonso Wolfango Avolio.

Several therapeutic procedures have been proposed as bridging treatments for patients with hepatocellular carcinoma (HCC) awaiting liver transplantation (LT). The most used treatments include transarterial chemoembolization and radiofrequency ablation. Surgical resection has also been successfully used as a bridging procedure, and LT should be considered a rescue treatment in patients with previous HCC resection who experience tumor recurrence or post-treatment severe decompensation of liver function. The aims of bridging treatments include decreasing the waiting list dropout rate before transplantation, reducing HCC recurrence after transplantation, and improving post-transplant overall survival. To date, no data from prospective randomized studies are available; however, for HCC patients listed for LT within the Milan criteria, prolonging the waiting time over 6-12 mo is a risk factor for tumor spread. Bridging treatments are useful in containing tumor progression and decreasing dropout. Furthermore, the response to pre-LT treatments may represent a surrogate marker of tumor biological aggressiveness and could therefore be evaluated to prioritize HCC candidates for LT. Lastly, although a definitive conclusion can not be reached, the experiences reported to date suggest a positive impact of these treatments on both tumor recurrence and post-transplant patient survival. Advanced HCC may be downstaged to achieve and maintain the current conventional criteria for inclusion in the waiting list for LT. Recent studies have demonstrated that successfully downstaged patients can achieve a 5-year survival rate comparable to that of patients meeting the conventional criteria without requiring downstaging.

01 diciembre 2013

CARDIOVASCULAR AND INTERVENTIONAL RADIOLOGY. Root Cause Analysis of Gastroduodenal Ulceration After Yttrium-90 Radioembolization

Marnix G. E. H. Lam, Subhas Banerjee, John D. Louie, Mohamed H. K. Abdelmaksoud, Andrei H. Iagaru, Rebecca E. Ennen, Daniel Y. Sze

Introduction: A root cause analysis was performed on the occurrence of gastroduodenal ulceration after hepatic radioembolization (RE). We aimed to identify the risk factors in the treated population and to determine the specific mechanism of nontarget RE in individual cases.

01 julio 2013

CARDIOVASCULAR AND INTERVENTIONAL RADIOLOGY. Selective Internal Radiotherapy (SIRT) of Hepatic Tumors: How to Deal with the Cystic Artery

Jens M. Theysohn, Stefan Müller, Jörg F. Schlaak, Judith Ertle, Thomas W. Schlosser, Andreas Bockisch, Thomas C. Lauenstein

Purpose: Selective internal radiotherapy (SIRT) with the beta emitter yttrium-90 (Y90) is a rapidly developing therapy option for unresectable liver malignancies. Nontarget irradiation of the gallbladder is a complication of SIRT. Thus, we aimed to assess different strategies to avoid infusion of Y90 into the cystic artery (CA).

01 julio 2013

NICE. Selective internal radiation therapy for primary hepatocellular carcinoma


Current evidence on the efficacy and safety of selective internal radiation therapy (SIRT) for primary hepatocellular carcinoma is adequate for use with normal arrangements for clinical governance, consent and audit. Uncertainties remain about its comparative effectiveness, and clinicians are encouraged to enter eligible patients into trials comparing the procedure against other forms of treatment.

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