title: Super selective radio embolization of the porcine kidney with 90yttrium resin microspheres: a feasibility, safety and dose ranging study.
abstract: OBJECTIVE
  We determined whether super selective radio embolization of the porcine kidney was technically feasible and evaluated histopathological changes in the treatment target zone (upper or lower renal pole), adjacent nontargeted kidney, and adjacent and distant organs after administering (90)Y labeled vs bland resin microspheres.
  
  
  METHODS
  We performed super selective radio embolization with (90)Y resin microspheres in 1 kidney and with an equivalent number of bland microspheres in the corresponding pole of the contralateral kidney as a control. The aim was to achieve radio embolization of a target zone equivalent to approximately a third of the kidney volume. A pathologist independently graded macroscopic and microscopic changes in the kidney, and adjacent and distant tissue resulting from incremental increases (0.15 to 0.35 GBq) in implanted activity in 6 pigs.
  
  
  RESULTS
  We recorded grade 4 histological changes in the treatment target zone (upper or lower renal pole) in 5 of 6 pigs after injecting (90)Y resin microspheres with evidence of nephron sparing effects in the adjacent renal tissue at the lowest activity. At activity greater than 0.3 GBq increasing damage was noted to adjacent renal tissue beyond the treatment target zone. No toxicity was evident in adjacent or distant organs.
  
  
  CONCLUSIONS
  Delivery of highly targeted intra-arterial radiotherapy to the kidney is feasible and safe in the pig model. Further evaluation is warranted as a potential treatment for advanced renal cell carcinoma or for localized disease in patients who are not candidates for surgery.
authors.affiliation: Department of Urology, Western General Hospital, Edinburgh, Scotland. mackie@doctors.org.uk
authors.forename: Simon
authors.initials: S
authors.lastname: MacKie
authors.forename: Suresh
authors.initials: S
authors.lastname: de Silva
authors.forename: Peter
authors.initials: P
authors.lastname: Aslan
authors.forename: Leigh
authors.initials: L
authors.lastname: Ladd
authors.forename: Michelle
authors.initials: M
authors.lastname: Houang
authors.forename: David
authors.initials: D
authors.lastname: Cade
authors.forename: Warwick
authors.initials: W
authors.lastname: Delprado
mesh_terms: D000818:Animals; D004621:Embolization, Therapeutic / Q000379:methods*; D005240:Feasibility Studies; D007668:Kidney / Q000473:pathology / Q000528:radiation effects*; D008863:Microspheres; D011879:Radiotherapy Dosage; D012117:Resins, Synthetic; D012449:Safety; D013552:Swine; D015021:Yttrium Radioisotopes / Q000627:therapeutic use*
chemical_list: D012117:Resins, Synthetic; D015021:Yttrium Radioisotopes