Hyo-Cheol Kim1, Yoon Jun Kim2, Jin Chul Paeng3, Jin Wook Chung4. 1. Department of Radiology, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea. Electronic address: angiointervention@gmail.com. 2. Department of Internal Medicine, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea. 3. Department of Nuclear Medicine, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea. 4. Department of Radiology, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea.
Abstract
PURPOSE: To address the feasibility of infusion of yttrium-90 (90Y) glass microspheres directly through the right inferior phrenic artery (RIPA). MATERIALS AND METHODS: From November 2015 to May 2017, 20 patients underwent 90Y radioembolization through the RIPA. When the systemic-to-pulmonary shunt was demonstrated on C-arm computed tomography (CT) of the RIPA, prophylactic embolization by polyvinyl alcohol (PVA) particles was performed prior to infusion of 90Y glass microspheres. Follow-up CT scans were retrospectively reviewed for pulmonary complications. Tumor response was determined by the modified Response Evaluation Criteria in Solid Tumors. RESULTS: Nine (45%) patients had systemic-to-pulmonary shunts on C-arm CT images of the RIPA. The feeder of the systemic-to-pulmonary shunt was the azygoesophageal branch (n = 7) and the anterior branch (n = 2). The mean activity of 90Y glass microspheres infused into the RIPA was 0.49 GBq (range, 0.19-1.55 GBq). No patient had symptomatic radiation pneumonitis or cutaneous complications during follow-up. Seven patients had focal atelectasis (n = 5), focal ground-glass opacity (n = 2), and/or a small amount of pleural effusion (n = 2) on follow-up image. Best tumor response fed by the RIPA was complete response (n = 4), partial response (n = 9), stable disease (n = 2), progressive disease (n = 4), and unevaluable (n = 1). CONCLUSION: The administration of 90Y glass microspheres through the RIPA may be safe after embolization of a systemic-to-pulmonary shunt identified on C-arm CT.
PURPOSE: To address the feasibility of infusion of yttrium-90 (90Y) glass microspheres directly through the right inferior phrenic artery (RIPA). MATERIALS AND METHODS: From November 2015 to May 2017, 20 patients underwent 90Y radioembolization through the RIPA. When the systemic-to-pulmonary shunt was demonstrated on C-arm computed tomography (CT) of the RIPA, prophylactic embolization by polyvinyl alcohol (PVA) particles was performed prior to infusion of 90Y glass microspheres. Follow-up CT scans were retrospectively reviewed for pulmonary complications. Tumor response was determined by the modified Response Evaluation Criteria in Solid Tumors. RESULTS: Nine (45%) patients had systemic-to-pulmonary shunts on C-arm CT images of the RIPA. The feeder of the systemic-to-pulmonary shunt was the azygoesophageal branch (n = 7) and the anterior branch (n = 2). The mean activity of 90Y glass microspheres infused into the RIPA was 0.49 GBq (range, 0.19-1.55 GBq). No patient had symptomatic radiation pneumonitis or cutaneous complications during follow-up. Seven patients had focal atelectasis (n = 5), focal ground-glass opacity (n = 2), and/or a small amount of pleural effusion (n = 2) on follow-up image. Best tumor response fed by the RIPA was complete response (n = 4), partial response (n = 9), stable disease (n = 2), progressive disease (n = 4), and unevaluable (n = 1). CONCLUSION: The administration of 90Y glass microspheres through the RIPA may be safe after embolization of a systemic-to-pulmonary shunt identified on C-arm CT.
Authors: Hyo-Cheol Kim; Myungsu Lee; Jeong-Hoon Lee; Jin Chul Paeng; Yoon Jun Kim; Jin Wook Chung Journal: In Vivo Date: 2020 Sep-Oct Impact factor: 2.155
Authors: Minseok Albert Kim; Heejoon Jang; Na Ryung Choi; Joon Yeul Nam; Yun Bin Lee; Eun Ju Cho; Jeong-Hoon Lee; Su Jong Yu; Hyo-Cheol Kim; Jin Wook Chung; Jung-Hwan Yoon; Yoon Jun Kim Journal: J Hepatocell Carcinoma Date: 2021-12-07