title: Clinical practice in radioembolization of hepatic malignancies: a survey among interventional centers in Europe.
abstract: OBJECTIVE
  A survey was conducted to give an overview about the practice of radioembolization in malignant liver tumors by European centers.
  
  
  METHODS
  A questionnaire of 23 questions about the interventional center, preinterventional patient evaluation, the radioembolization procedure and aftercare were sent to 45 European centers.
  
  
  RESULTS
  The response rate was 62.2% (28/45). The centers performed 1000 (median = 26) radioembolizations in 2009 and 1292 (median = 40) in 2010. Most centers perform preinterventional evaluation and radioembolization on an inpatient basis. An arterioportal shunt not amendable to preinterventional embolization is considered a contraindication. During preinterventional angiography, the gastroduodenal artery is embolized by 71%, the right gastric artery by 59%, and the cystic artery by 41%. In case of bilobar disease, yttrium-90 microspheres are infused into the common hepatic artery (14%) or separately into left and right hepatic artery (86%). 33% prefer a time interval between right and left liver lobe radioembolization to prevent radiation induced liver disease. 43% of the respondents do not prescribe prophylactic medication after radioembolization. In case of iatrogenic manipulation to the biliary duct system most centers perform radioembolization with prophylactic antibiotics.
  
  
  CONCLUSIONS
  Despite standardization of the procedure, there are some differences in how radioembolization of liver tumors is performed in Europe.
authors.affiliation: Department of Radiology, Charité - Universitätsmedizin Berlin, Hindenburgdamm 30, 12203 Berlin, Germany. maciej-janusz.powerski@charite.de
authors.forename: Maciej Janusz
authors.initials: MJ
authors.lastname: Powerski
authors.forename: Christian
authors.initials: C
authors.lastname: Scheurig-Münkler
authors.forename: Jan
authors.initials: J
authors.lastname: Banzer
authors.forename: Dirk
authors.initials: D
authors.lastname: Schnapauff
authors.forename: Bernd
authors.initials: B
authors.lastname: Hamm
authors.forename: Bernhard
authors.initials: B
authors.lastname: Gebauer
mesh_terms: D001918:Brachytherapy / Q000379:methods*; D003131:Combined Modality Therapy; D004621:Embolization, Therapeutic / Q000379:methods*; D005060:Europe; D006801:Humans; D008113:Liver Neoplasms / Q000532:radiotherapy / Q000628:therapy*; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data*; D015641:Radiography, Interventional; D011795:Surveys and Questionnaires; D015021:Yttrium Radioisotopes / Q000627:therapeutic use*
chemical_list: D015021:Yttrium Radioisotopes