Gastrointestinal complications associated with hepatic arterial Yttrium-90 microsphere therapy.
Hepatic arterial therapy with yttrium-90 microspheres exploits the avenue provided by the neoplastic microvasculature to deliver high-energy, low-penetrating therapeutic doses of radiation. Variant hepatic arterial anatomy, collateral vessels, and changes in flow dynamics during treatment can affect particle dispersion and lead to nontarget particle distribution and subsequent gastrointestinal morbidity. Awareness of these variances and techniques to prevent gastrointestinal tract microsphere delivery is essential in mitigating this serious complication. Our aim is to increase the understanding of the role of various imaging and preventative techniques in minimizing this undesired effect.
Murthy
Ravi
R
Division of Diagnostic Imaging, The University of Texas M. D. Anderson Cancer Center, 1515 Holcombe Boulevard, Houston, TX 77030, USA. rmurthy@di.mdacc.tmc.edu
Brown
Daniel B
DB
Salem
Riad
R
Meranze
Steven G
SG
Coldwell
Douglas M
DM
Krishnan
Sunil
S
Nunez
Rodolfo
R
Habbu
Amit
A
Liu
David
D
Ross
William
W
Cohen
Alan M
AM
Censullo
Michael
M
D000230:Adenocarcinoma / Q000000981:diagnostic imaging / Q000532:radiotherapy* / Q000556:secondary; D000328:Adult; D000368:Aged; D001918:Brachytherapy / Q000009:adverse effects*; D004621:Embolization, Therapeutic / Q000009:adverse effects*; D041981:Gastrointestinal Tract / Q000098:blood supply; D006499:Hepatic Artery; D006801:Humans; D007269:Injections, Intra-Arterial; D008113:Liver Neoplasms / Q000000981:diagnostic imaging / Q000532:radiotherapy* / Q000556:secondary; D008297:Male; D008863:Microspheres; D010437:Peptic Ulcer / Q000150:complications / Q000209:etiology* / Q000473:pathology; D010438:Peptic Ulcer Hemorrhage / Q000209:etiology* / Q000473:pathology; D011877:Radionuclide Imaging; D019275:Radiopharmaceuticals; D012189:Retrospective Studies; D013668:Technetium Tc 99m Aggregated Albumin; D015021:Yttrium Radioisotopes / Q000008:administration & dosage / Q000009:adverse effects*
D019275:Radiopharmaceuticals; D013668:Technetium Tc 99m Aggregated Albumin; D015021:Yttrium Radioisotopes