Same day yttrium-90 radioembolization with single photon emission computed tomography/computed tomography: An opportunity to improve care during the COVID-19 pandemic and beyond
| Autor: | Keywan Behbahani, Nima Kokabi, Mohammad Elsayed, Richard Duszak, Ila Sethi, Zachary L. Bercu, David Brandon, Mohammad Loya, David M. Schuster, Janice Newsome, Sonia Benenati, James R. Galt |
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| Rok vydání: | 2020 |
| Předmět: |
musculoskeletal diseases
2019-20 coronavirus outbreak Coronavirus disease 2019 (COVID-19) Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) Same day Selective internal radiotherapy Observational Study Transarterial radioembolization Computed tomography Single-photon emission computed tomography Transarterial Radioembolization 03 medical and health sciences 0302 clinical medicine Dosimetry Yttrium-90 radioembolization medicine medicine.diagnostic_test business.industry Gastroenterology COVID-19 surgical procedures operative Oncology 030220 oncology & carcinogenesis 030211 gastroenterology & hepatology Single photon emission computed tomography/computed tomography Nuclear medicine business |
| Zdroj: | World Journal of Gastrointestinal Oncology |
| ISSN: | 1948-5204 |
| Popis: | BACKGROUND The coronavirus disease 2019 (COVID-19) pandemic has made it more challenging for patients to undergo yttrium-90 (Y-90) radioembolization (RE). Same day Y-90 RE provides an opportunity to minimize logistical challenges and infection risk associated with COVID-19, thus improving patient access. AIM To describe the use of same day Y-90 RE with routine single photon emission computed tomography/computed tomography (SPECT/CT) in order to optimize therapy. METHODS All patients were selected for Y-90 RE through a multidisciplinary tumor board, and were screened and tested for COVID-19 infection per institutional protocol. A same day procedure was developed, consisting of angiography, imaging, and Y-90 resin particle delivery. Routine SPECT/CT after technetium-99m macroaggregated albumin (Tc-99m MAA) administration was performed for assessment of arterial supply, personalized dosimetry, and extrahepatic activity. Post-treatment Y-90 bremsstrahlung SPECT/CT was performed for confirmation of particle delivery, by utilization of energy windowing to limit signal from previously administered Tc-99m MAA particles. RESULTS A total of 14 patients underwent same day Y-90 RE between March and June 2020. Mean lung shunt fraction was 6.13% (range 3.5%-13.1%). Y-90 RE was performed for a single lesion in 7 patients, while the remaining 7 patients had treatment of multifocal lesions. The largest lesion measured 8.3 cm. All patients tolerated the procedure well and were discharged the same day. CONCLUSION Same day Y-90 RE with resin-based microspheres is feasible, and provides an opportunity to mitigate infection risk and logistical challenges associated with the COVID-19 pandemic and beyond. We recommend consideration of SPECT/CT, especially among patients with complex malignancies, for the potential to improve outcomes and eligibility of patients to undergo same day Y-90 RE. |
| Databáze: | OpenAIRE |
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