Radioembolization with 90Y microspheres: angiographic and technical considerations.
The anatomy of the mesenteric system and the hepatic arterial bed has been demonstrated to have a high degree of variation. This is important when considering pre-surgical planning, catheterization, and trans-arterial hepatic therapies. Although anatomical variants have been well described, the characterization and understanding of regional hepatic perfusion in the context of radioembolization have not been studied with great depth. The purpose of this review is to provide a thorough discussion and detailed presentation of the angiographic and technical aspects of radioembolization. Normal vascular anatomy, commonly encountered variants, and factors involved in changes to regional perfusion in the presence of liver tumors are discussed. Furthermore, the principles described here apply to all liver-directed transarterial therapies.
Lewandowski
Robert J
RJ
Department of Radiology, Section of Interventional Radiology, Northwestern Memorial Hospital, Robert H. Lurie Comprehensive Cancer Center, Chicago, IL, USA.
Sato
Kent T
KT
Atassi
Bassel
B
Ryu
Robert K
RK
Nemcek
Albert A
AA
Kulik
Laura
L
Geschwind
Jean-Francois
JF
Murthy
Ravi
R
Rilling
William
W
Liu
David
D
Bester
Lourens
L
Bilbao
Jose Ignacio
JI
Kennedy
Andrew S
AS
Omary
Reed A
RA
Salem
Riad
R
D000792:Angiography / Q000379:methods*; D001918:Brachytherapy / Q000379:methods*; D006528:Carcinoma, Hepatocellular / Q000098:blood supply / Q000000981:diagnostic imaging / Q000532:radiotherapy*; D002406:Catheterization, Peripheral / Q000379:methods; D002445:Celiac Artery / Q000002:abnormalities / Q000000981:diagnostic imaging; D004621:Embolization, Therapeutic / Q000379:methods*; D006499:Hepatic Artery / Q000002:abnormalities / Q000000981:diagnostic imaging*; D006801:Humans; D007261:Infusions, Intra-Arterial / Q000379:methods; D008099:Liver / Q000098:blood supply; D008113:Liver Neoplasms / Q000098:blood supply / Q000000981:diagnostic imaging / Q000532:radiotherapy*; D018810:Magnetic Resonance Angiography; D008638:Mesenteric Arteries / Q000002:abnormalities / Q000000981:diagnostic imaging; D008863:Microspheres; D009389:Neovascularization, Pathologic / Q000000981:diagnostic imaging / Q000532:radiotherapy; D012039:Regional Blood Flow / Q000502:physiology; D013270:Stomach / Q000098:blood supply; D014057:Tomography, X-Ray Computed; D015021:Yttrium Radioisotopes / Q000627:therapeutic use*
D015021:Yttrium Radioisotopes