OBJECTIVES: We report a first experience involving the use of (90)Y radiolabelled microspheres (TheraSphere) for the treatment of mainly primary hepatic tumours. MATERIALS AND METHODS: Treatment using TheraSphere microspheres was planned in 15 patients (13 with hepatocellular carcinoma, 2 with neuroendocrine tumour metastases). The treatment was preceded by a first angiography aimed at embolizing the vascularizing arterial branches of other structures outside the liver and evaluating the percentage of pulmonary shunt by scintiscanning after perfusion with (99m)Tc-MAA. The objective of the treatment carried out during a second angiography was to deliver a dose of 120+/-20 Gy (mean+/-SD) to the target hepatic volume. RESULTS: Technical difficulties were encountered in embolizing gastroduodenal or gastric branches in two patients and in one patient these led to cancellation of the treatment. A total of 14 patients were treated with an average activity of 3.18 GBq. In one patient, the injection was defective (stagnation of microspheres at the outlet of the catheter). SPECT/CT acquisitions provided important information in four patients (visualization of the gallbladder in three; visualization of the stomach in one, leading to a new coiling). The average exposure of the nuclear medicine physician carrying out the injections was 64+/-80 microSv at the fingers. A partial response was seen in six patients, stabilization in five and progression in three. One patient presented with a gastric ulcer and two showed an increase in their hepatocellular insufficiency. CONCLUSION: Although sometimes technically difficult, the use of TheraSphere microspheres is a worthwhile therapeutic approach because of the low level exposure of operators and the encouraging rate of response or stabilization. The use of SPECT/CT contributes greatly to helping therapeutic planning, especially in the learning curve or when the angiographic procedure is difficult.
OBJECTIVES: We report a first experience involving the use of (90)Y radiolabelled microspheres (TheraSphere) for the treatment of mainly primary hepatic tumours. MATERIALS AND METHODS: Treatment using TheraSphere microspheres was planned in 15 patients (13 with hepatocellular carcinoma, 2 with neuroendocrine tumour metastases). The treatment was preceded by a first angiography aimed at embolizing the vascularizing arterial branches of other structures outside the liver and evaluating the percentage of pulmonary shunt by scintiscanning after perfusion with (99m)Tc-MAA. The objective of the treatment carried out during a second angiography was to deliver a dose of 120+/-20 Gy (mean+/-SD) to the target hepatic volume. RESULTS: Technical difficulties were encountered in embolizing gastroduodenal or gastric branches in two patients and in one patient these led to cancellation of the treatment. A total of 14 patients were treated with an average activity of 3.18 GBq. In one patient, the injection was defective (stagnation of microspheres at the outlet of the catheter). SPECT/CT acquisitions provided important information in four patients (visualization of the gallbladder in three; visualization of the stomach in one, leading to a new coiling). The average exposure of the nuclear medicine physician carrying out the injections was 64+/-80 microSv at the fingers. A partial response was seen in six patients, stabilization in five and progression in three. One patient presented with a gastric ulcer and two showed an increase in their hepatocellular insufficiency. CONCLUSION: Although sometimes technically difficult, the use of TheraSphere microspheres is a worthwhile therapeutic approach because of the low level exposure of operators and the encouraging rate of response or stabilization. The use of SPECT/CT contributes greatly to helping therapeutic planning, especially in the learning curve or when the angiographic procedure is difficult.
Authors: J H Risse; F Grünwald; W Kersjes; H Strunk; W H Caselmann; H Palmedo; H Bender; H J Biersack Journal: Cancer Biother Radiopharm Date: 2000-02 Impact factor: 3.099
Authors: S Houle; T K Yip; F A Shepherd; L E Rotstein; K W Sniderman; E Theis; R H Cawthorn; K Richmond-Cox Journal: Radiology Date: 1989-09 Impact factor: 11.105
Authors: E Garin; S Laffont; Y Rolland; D Olivie; J Lecloirec; J-Y Herry; E Boucher; J-L Raoul; P Bourguet Journal: Nucl Med Commun Date: 2003-06 Impact factor: 1.690
Authors: Riad Salem; Kenneth G Thurston; Brian I Carr; James E Goin; Jean-Francois H Geschwind Journal: J Vasc Interv Radiol Date: 2002-09 Impact factor: 3.464
Authors: Josep M Llovet; Sergio Ricci; Vincenzo Mazzaferro; Philip Hilgard; Edward Gane; Jean-Frédéric Blanc; Andre Cosme de Oliveira; Armando Santoro; Jean-Luc Raoul; Alejandro Forner; Myron Schwartz; Camillo Porta; Stefan Zeuzem; Luigi Bolondi; Tim F Greten; Peter R Galle; Jean-François Seitz; Ivan Borbath; Dieter Häussinger; Tom Giannaris; Minghua Shan; Marius Moscovici; Dimitris Voliotis; Jordi Bruix Journal: N Engl J Med Date: 2008-07-24 Impact factor: 91.245
Authors: Riad Salem; Robert J Lewandowski; Vanessa L Gates; Charles W Nutting; Ravi Murthy; Steven C Rose; Michael C Soulen; Jean-Francois H Geschwind; Laura Kulik; Yun Hwan Kim; Carlo Spreafico; Marco Maccauro; Lourens Bester; Daniel B Brown; Robert K W Ryu; Daniel Y Sze; William S Rilling; Kent T Sato; Bruno Sangro; Jose Ignacio Bilbao; Tobias F Jakobs; Samer Ezziddin; Suyash Kulkarni; Aniruddha Kulkarni; David M Liu; David Valenti; Philip Hilgard; Gerald Antoch; Stefan P Muller; Hamad Alsuhaibani; Mary F Mulcahy; Marta Burrel; Maria Isabel Real; Stewart Spies; Abdulredha A Esmail; Jean-Luc Raoul; Etienne Garin; Mathew S Johnson; Al B Benson; Ricky A Sharma; Harpreet Wasan; Bieke Lambert; Khairuddin Memon; Andrew S Kennedy; Ahsun Riaz Journal: J Vasc Interv Radiol Date: 2011-03 Impact factor: 3.464
Authors: M W Barentsz; M A D Vente; M G E H Lam; M L J Smits; J F W Nijsen; B A Seinstra; C E N M Rosenbaum; H M Verkooijen; B A Zonnenberg; M A A J Van den Bosch Journal: Cardiovasc Intervent Radiol Date: 2010-12-30 Impact factor: 2.740
Authors: Maarten L J Smits; Andor F van den Hoven; Charlotte E N M Rosenbaum; Bernard A Zonnenberg; Marnix G E H Lam; Johannes F W Nijsen; Miriam Koopman; Maurice A A J van den Bosch Journal: PLoS One Date: 2013-07-24 Impact factor: 3.240