| Incorporating cone-beam CT into the treatment planning for yttrium-90 radioembolization. | |
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MedLine Citation:
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PMID: 19345589 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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PURPOSE: To prepare for yttrium-90 ((90)Y) microsphere radioembolization therapy, digital subtraction angiography (DSA) and technetium- 99m-labeled macroaggregated albumin ((99m)Tc MAA) scintigraphy are used for treatment planning and detection of potential nontarget embolization. The present study was performed to determine if cone-beam computed tomography (CBCT) affects treatment planning as an adjunct to these conventional imaging modalities. MATERIALS AND METHODS: From March 2007 to August 2008, 42 consecutive patients (21 men, 21 women; mean age, 59 years; range, 21-75 y) who underwent radioembolization were evaluated by CBCT in addition to DSA and (99m)Tc MAA scintigraphy during treatment planning, and their records were retrospectively reviewed. The contrast-enhanced territories shown by CBCT with selective intraarterial contrast agent administration were used to predict intrahepatic and possible extrahepatic distribution of microspheres. RESULTS: In 22 of 42 cases (52%), extrahepatic enhancement or incomplete tumor perfusion seen on CBCT affected the treatment plan. In 14 patients (33%), the findings were evident exclusively on CBCT and not detected by DSA. When comparing CBCT versus (99m)Tc MAA scintigraphy, CBCT showed eight cases of extrahepatic enhancement (19%) that were not evident on (99m)Tc MAA imaging. CBCT findings directed the additional embolization of vessels or repositioning of the catheter for better contrast agent and microsphere distribution. One case of gastric ulcer from nontarget embolization caused by reader error was observed. CONCLUSIONS: CBCT can provide additional information about tumor and tissue perfusion not currently detectable by DSA or (99m)Tc MAA imaging, which should optimize (90)Y microsphere delivery and reduce nontarget embolization. |
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Authors:
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John D Louie; Nishita Kothary; William T Kuo; Gloria L Hwang; Lawrence V Hofmann; Michael L Goris; Andrei H Iagaru; Daniel Y Sze |
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Publication Detail:
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Type: Clinical Trial; Journal Article; Research Support, Non-U.S. Gov't Date: 2009-04-05 |
Journal Detail:
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Title: Journal of vascular and interventional radiology : JVIR Volume: 20 ISSN: 1535-7732 ISO Abbreviation: J Vasc Interv Radiol Publication Date: 2009 May |
Date Detail:
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Created Date: 2009-04-27 Completed Date: 2009-07-09 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 9203369 Medline TA: J Vasc Interv Radiol Country: United States |
Other Details:
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Languages: eng Pagination: 606-13 Citation Subset: IM |
Affiliation:
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Department of Radiology, Stanford University Medical Center, CA 94305-5642, USA. jdlouie@stanford.edu |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Adult Aged Cone-Beam Computed Tomography / methods* Embolization, Therapeutic / methods* Female Humans Liver Neoplasms / radiography, radiotherapy* Male Middle Aged Radiography, Interventional / methods* Radiopharmaceuticals / diagnostic use Radiotherapy Dosage Radiotherapy Planning, Computer-Assisted / methods* Treatment Outcome Yttrium Radioisotopes / therapeutic use* |
| Chemical | |
Reg. No./Substance:
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0/Radiopharmaceuticals; 0/Yttrium Radioisotopes |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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