Management of High Hepatopulmonary Shunts in the Setting of Y90 Radioembolization

Tech Vasc Interv Radiol. 2019 Jun;22(2):58-62. doi: 10.1053/j.tvir.2019.02.004. Epub 2019 Feb 27.

Abstract

Treatment paradigms for primary and metastatic malignancies involving the liver have evolved in recent years to include targeted liver therapies. Transarterial radioembolization is at the forefront of therapy in many treatment algorithms. However, due to significant hepatopulmonary shunting, some patients are excluded from this proven treatment due to the possibility of radiation-induced lung injury. In this article, we review techniques to mitigate hepatopulmonary shunts to improve the likelihood of inclusion and successful treatment in these patients.

Keywords: hepatopulmonary shunt; radiation induced lung disease; radioembolization.

MeSH terms

  • Embolization, Therapeutic / methods*
  • Hepatopulmonary Syndrome / prevention & control*
  • Humans
  • Liver Neoplasms / diagnostic imaging
  • Liver Neoplasms / radiotherapy*
  • Microspheres
  • Patient Care Planning
  • Patient Selection
  • Radiation Injuries / prevention & control*
  • Radiotherapy Dosage
  • Yttrium Radioisotopes / therapeutic use*

Substances

  • Yttrium Radioisotopes
  • Yttrium-90