Catheter-Directed Computed Tomography Hepatic Angiography for Yttrium-90 Selective Internal Radiotherapy of Hepatocellular Carcinoma Reduces Prophylactic Embolization of Extrahepatic Vessels
| Autor: | Seyed Ehsan Saffari, Bien Soo Tan, Nanda Venkatanarasimha, Luke Han Wei Toh, Sum Leong, Kelvin Siu Hoong Loke, Rebekah Zhuyi Lee, David Chee Eng Ng, F. Irani, Lionel Tim-Ee Cheng, Pierce K. H. Chow, Winfred Xi Tai Goh, Kiang Hiong Tay, Chow Wei Too, K. Damodharan, Sean Tze Shen Ng, R. Lo, Shaun Xavier Ju Min Chan, A. Patel, Apoorva Gogna, Thijs August Johan Urlings |
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| Rok vydání: | 2019 |
| Předmět: |
Male
medicine.medical_specialty Carcinoma Hepatocellular Catheters Computed Tomography Angiography medicine.medical_treatment Brachytherapy Radiography Interventional Hepatic Artery medicine Humans Yttrium Radioisotopes Radiology Nuclear Medicine and imaging Embolization Retrospective Studies Pneumonitis medicine.diagnostic_test business.industry Gallbladder Liver Neoplasms Retrospective cohort study Digital subtraction angiography Middle Aged medicine.disease Radiation therapy Catheter medicine.anatomical_structure Liver Hepatocellular carcinoma Female Radiology Cardiology and Cardiovascular Medicine business |
| Zdroj: | CardioVascular and Interventional Radiology. 43:478-487 |
| ISSN: | 1432-086X 0174-1551 |
| Popis: | To determine the rate of prophylactic embolization of extrahepatic vessels in patients undergoing yttrium-90 selective internal radiotherapy (90Y SIRT) for hepatocellular carcinoma (HCC) with the use of catheter-directed computed tomography hepatic angiography (CD-CTHA). This retrospective study included 186 HCC patients who received 90Y SIRT from May 2010 to June 2015 in a single institution. All procedures were performed in a hybrid angiography-CT suite equipped with digital subtraction angiography (DSA) and CD-CTHA capabilities. CD-CTHA was performed during pre-treatment hepatic angiography. 90Y SIRT was administered approximately 2 weeks later. Selective prophylactic embolization of extrahepatic vessels was performed if extrahepatic enhancement was seen on CD-CTHA or if an extrahepatic vessel opacified on DSA/CD-CTHA despite the final microcatheter position for 90Y microsphere delivery being beyond the origin of this vessel. Thirty-five patients (18.8%) required selective embolization of extrahepatic vessels. Technical success of 90Y SIRT was 99.5%. Two patients (1.1%) developed radiation-induced gastrointestinal ulceration, and one (0.54%) developed radiation-induced pneumonitis. Extrahepatic uptake of 90Y microspheres was seen in the gallbladder of one patient without significant complications. The use of CD-CTHA in 90Y SIRT of HCC was associated with a low rate of prophylactic embolization of extrahepatic vessels while maintaining a high technical success rate of treatment and low rate of complications. Level 4, case series. |
| Databáze: | OpenAIRE |
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