Purpose: To investigate the feasibility of yttrium-90 ((90)Y) glass microsphere radioembolization (including angiography, lung shunt assessment, and treatment) as a single-session, outpatient procedure.
Materials and methods: Between January 2008 and June 2013, 14 patients underwent outpatient, single-session radioembolization with (90)Y glass microspheres. As part of the routine diagnostic work-up, all patients underwent either computed tomography (CT) or magnetic resonance imaging of the liver with three-dimensional analysis and had laboratory results forwarded to our center for confirmation of candidacy before treatment. On treatment day, all patients underwent planning mesenteric angiography with flat panel cone-beam CT imaging. Patients were administered 33-85 MBq of technetium-99m macroaggregated albumin ((99m)Tc-MAA) via a microcatheter positioned in a hepatic artery supplying the tumor of interest. Planar scintigraphy was initiated within 2 hours after the administration of (99m)Tc-MAA and lung shunt fraction was determined. Final dosimetry calculations were performed while the patient was being transferred back from nuclear medicine to interventional radiology.
Results: All patients successfully underwent planning angiography with administration of (99m)Tc-MAA and (90)Y radioembolization as a single-session treatment. There were no reportable or recordable medical events; treatment was carried out to the desired dose in all cases. The mean total procedure time was 2.70 hours ± 0.72 (range, 1.63-3.97 h).
Conclusions: This study reports a novel proof of concept for performing radioembolization in a single-session setting. By using the described method, time between initial clinical assessments and radioembolization treatment is decreased, and costs are minimized.
Keywords: (90)Y; (99m)Tc-MAA; DSA; LSF; MIRD; SPECT; digital subtraction angiography; lung shunt fraction; medical internal radiation dose; single photon emission computed tomography; technetium-99m macroaggregated albumin; yttrium-90.
© 2014 Published by SIR on behalf of SIR.