title: Transcatheter arterial embolization with spherical embolic agent for pulmonary metastases from renal cell carcinoma.
abstract: OBJECTIVE
  This retrospective study aimed to evaluate the safety and local efficacy of transcatheter arterial embolization (TAE) with superabsorbent polymer microspheres (SAP-MS) in patients with pulmonary metastases from renal cell carcinoma (RCC).
  
  
  METHODS
  Sixteen patients with unresectable pulmonary metastases from RCC refractory to standard therapy were enrolled to undergo TAE with the purpose of mass reduction and/or palliation. The prepared SAP-MS swell to approximately two times larger than their dry-state size (100-150 μm [n = 14], 50-100 μm [n = 2]). Forty-nine pulmonary nodules (lung n = 22, mediastinal lymph node n = 17, and hilar lymph node n = 10) were selected as target lesions for evaluation. Local tumor response was evaluated 3 months after TAE according to Response Evaluation Criteria in Solid Tumors (RECIST; version 1.1). The relationship between tumor enhancement ratio by CT during selective angiography and local tumor response was evaluated.
  
  
  RESULTS
  The number of TAE sessions per patient ranged from 1 to 5 (median 2.9). Embolized arteries at initial TAE were bronchial arteries in 14 patients (87.5 %) and nonbronchial systemic arteries in 11 patients (68.8 %). Nodule-based evaluation showed that 5 (10.2 %) nodules had complete response, 17 (34.7 %) had partial response, 15 (30.6 %) had stable disease, and 12 (24.5 %) had progressive disease. The response rate was significantly greater in 22 lesions that had a high tumor enhancement ratio than in 27 lesions that had a slight or moderate ratio (90.9 vs. 7.4 %, p = 0.01). Severe TAE-related adverse events did not occur.
  
  
  CONCLUSIONS
  TAE with SAP-MS might be a well-tolerated and locally efficacious palliative option for patients with pulmonary metastases from RCC.
authors: Department of Radiology, Gate Tower Institute for Image Guided Therapy, 11F, Gate Tower Building, 1-Rinku Ohrai-Kita, Izumisanocity, Osaka, 598-0048, Japan. sekia@igtc.jp.
authors: Akihiko
authors: A
authors: Seki
authors: Department of Radiology, Gate Tower Institute for Image Guided Therapy, 11F, Gate Tower Building, 1-Rinku Ohrai-Kita, Izumisanocity, Osaka, 598-0048, Japan.
authors: Shinichi
authors: S
authors: Hori
authors: Department of Radiology, Gate Tower Institute for Image Guided Therapy, 11F, Gate Tower Building, 1-Rinku Ohrai-Kita, Izumisanocity, Osaka, 598-0048, Japan.
authors: Satoru
authors: S
authors: Sueyoshi
authors: Department of Radiology, Gate Tower Institute for Image Guided Therapy, 11F, Gate Tower Building, 1-Rinku Ohrai-Kita, Izumisanocity, Osaka, 598-0048, Japan.
authors: Atsushi
authors: A
authors: Hori
authors: Department of Radiology, Gate Tower Institute for Image Guided Therapy, 11F, Gate Tower Building, 1-Rinku Ohrai-Kita, Izumisanocity, Osaka, 598-0048, Japan.
authors: Michihiko
authors: M
authors: Kono
authors: Department of Radiology, Gate Tower Institute for Image Guided Therapy, 11F, Gate Tower Building, 1-Rinku Ohrai-Kita, Izumisanocity, Osaka, 598-0048, Japan.
authors: Shinichi
authors: S
authors: Murata
authors: Department of Radiology, Gate Tower Institute for Image Guided Therapy, 11F, Gate Tower Building, 1-Rinku Ohrai-Kita, Izumisanocity, Osaka, 598-0048, Japan.
authors: Masahiko
authors: M
authors: Maeda
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002292:Carcinoma, Renal Cell / Q000473:pathology*; D003371:Cough / Q000209:etiology; D018450:Disease Progression; D004417:Dyspnea / Q000209:etiology; D004621:Embolization, Therapeutic / Q000009:adverse effects / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006469:Hemoptysis / Q000209:etiology; D006801:Humans; D007680:Kidney Neoplasms / Q000473:pathology*; D008168:Lung / Q000000981:diagnostic imaging; D008175:Lung Neoplasms / Q000000981:diagnostic imaging / Q000556:secondary* / Q000628:therapy*; D008297:Male; D008863:Microspheres; D008875:Middle Aged; D010166:Palliative Care / Q000379:methods; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed / Q000379:methods; D016896:Treatment Outcome