Document Detail

Selective Internal Radiotherapy (SIRT) of Hepatic Tumors: How to Deal with the Cystic Artery.
MedLine Citation:
PMID:  22983697     Owner:  NLM     Status:  Publisher    
PURPOSE: Selective internal radiotherapy (SIRT) with the beta emitter yttrium-90 (Y90) is a rapidly developing therapy option for unresectable liver malignancies. Nontarget irradiation of the gallbladder is a complication of SIRT. Thus, we aimed to assess different strategies to avoid infusion of Y90 into the cystic artery (CA). METHODS: After hepatic digital subtraction angiography and administration of technetium-99m-labeled human serum albumin ((99)mTc-HSA), 295 patients with primary or secondary liver tumors underwent single-photon emission computed tomography/computed tomography (SPECT/CT). Different measures were taken before repeated Y90 mapping and SIRT to avoid unintended influx into the CA where necessary. Clinical symptoms, including pain, fever, or a positive Murphy sign, were assessed during patient follow-up. RESULTS: A significant (99)mTc-HSA accumulation in the gallbladder wall (higher (99)mTc-HSA uptake than in normal liver tissue) was seen in 20 patients. The following measures were taken to avoid unintended influx into the CA: temporary/permanent occlusion of the CA with gelfoam (n = 5)/microcoil (n = 1), induction of vasospasm with a microwire (n = 4), or altering catheter position (n = 10). Clinical signs of cholecystitis were observed in only one patient after temporary CA occlusion with gelfoam and were successfully treated by antibiotics. Cholecystectomy was not required for any patient. CONCLUSION: It is important to identify possible nontarget irradiation of the gallbladder. The risk for radiation-induced cholecystitis can be easily minimized by temporary or permanent CA embolization, vasospasm induction, or altering the catheter position.
Jens M Theysohn; Stefan Müller; Jörg F Schlaak; Judith Ertle; Thomas W Schlosser; Andreas Bockisch; Thomas C Lauenstein
Related Documents :
24580147 - Deferasirox for transfusion-dependent patients with myelodysplastic syndromes: safety, ...
23567257 - Femoroacetabular impingement: presence of fai-like features on conventional radiography...
23035757 - Personalized medicine in multiple sclerosis: hope or reality?
23674227 - Hydrocephalus associated with vestibular schwannomas: perioperative changes in cerebros...
12799747 - Free radicals in patients with post-traumatic stress disorder.
22454917 - A comparison of the effects of prostaglandin e(2) and salbutamol by intravenous infusio...
Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2012-9-15
Journal Detail:
Title:  Cardiovascular and interventional radiology     Volume:  -     ISSN:  1432-086X     ISO Abbreviation:  Cardiovasc Intervent Radiol     Publication Date:  2012 Sep 
Date Detail:
Created Date:  2012-9-17     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8003538     Medline TA:  Cardiovasc Intervent Radiol     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Department of Diagnostic and Interventional Radiology and Neuroradiology, University Hospital Essen, Hufelandstrasse 55, 45122, Essen, Germany,
Export Citation:
APA/MLA Format     Download EndNote     Download BibTex
MeSH Terms

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

Previous Document:  De Garengeot's hernia: a comprehensive review.
Next Document:  Everolimus-induced Pneumonitis after Drug-eluting Stent Implantation: A Case Report.