PURPOSE: To evaluate the efficacy of a workflow consisting of repeat assessment in patients planned for yttrium-90 ((90)Y) radioembolization in case of nontarget visceral technetium-99m ((99m)Tc)-macroaggregated albumin (MAA) accumulation despite initial prophylactic coil embolization of nonhepatic arteries. MATERIALS AND METHODS: In 341 patients with primary and secondary liver cancer, pretreatment hepatic angiograms, as well as single-photon emission computed tomography coregistered with magnetic resonance imaging scans, were obtained. Extrahepatic tracer deposition was identified in 33 patients (9.7%) necessitating repeat assessment. Images were reviewed to correlate the site of MAA accumulation with causative gastrointestinal vessels, and repeat angiograms served as reference standard. RESULTS: At repeat angiography, the source of extrahepatic flow was identified and eliminated in 31 of 33 patients (93.9%). In 20 patients (60.6%), successful embolization of nontarget vessels was achieved, in 13 patients (39.4%), MAA was administered more distally. Afterward, extrahepatic MAA deposition was eliminated in 30 patients (90.9%). CONCLUSION: The algorithm of repeat assessment in case of extrahepatic MAA accumulation has proven highly effective to eliminate extrahepatic shunting, thus decreasing the risk of postradioembolization complications due to inadvertent visceral microsphere deposition.
PURPOSE: To evaluate the efficacy of a workflow consisting of repeat assessment in patients planned for yttrium-90 ((90)Y) radioembolization in case of nontarget visceral technetium-99m ((99m)Tc)-macroaggregated albumin (MAA) accumulation despite initial prophylactic coil embolization of nonhepatic arteries. MATERIALS AND METHODS: In 341 patients with primary and secondary liver cancer, pretreatment hepatic angiograms, as well as single-photon emission computed tomography coregistered with magnetic resonance imaging scans, were obtained. Extrahepatic tracer deposition was identified in 33 patients (9.7%) necessitating repeat assessment. Images were reviewed to correlate the site of MAA accumulation with causative gastrointestinal vessels, and repeat angiograms served as reference standard. RESULTS: At repeat angiography, the source of extrahepatic flow was identified and eliminated in 31 of 33 patients (93.9%). In 20 patients (60.6%), successful embolization of nontarget vessels was achieved, in 13 patients (39.4%), MAA was administered more distally. Afterward, extrahepatic MAA deposition was eliminated in 30 patients (90.9%). CONCLUSION: The algorithm of repeat assessment in case of extrahepatic MAA accumulation has proven highly effective to eliminate extrahepatic shunting, thus decreasing the risk of postradioembolization complications due to inadvertent visceral microsphere deposition.
Authors: Andor F van den Hoven; Jip F Prince; Bart de Keizer; Evert-Jan P A Vonken; Rutger C G Bruijnen; Helena M Verkooijen; Marnix G E H Lam; Maurice A A J van den Bosch Journal: Cardiovasc Intervent Radiol Date: 2015-06-12 Impact factor: 2.740
Authors: Piotr Piasecki; Krzysztof Brzozowski; Piotr Ziecina; Marek Wierzbicki; Anna Budzynska; Andrzej Mazurek; Miroslaw Dziuk; Maciej Maciak; Edward Iller; Jerzy Narloch Journal: J Clin Med Date: 2019-09-24 Impact factor: 4.241
Authors: Jens M Theysohn; Marcus Ruhlmann; Stefan Müller; Alexander Dechene; Jan Best; Johannes Haubold; Lale Umutlu; Guido Gerken; Andreas Bockisch; Thomas C Lauenstein Journal: PLoS One Date: 2015-09-03 Impact factor: 3.240
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