title: Long-term follow-up study of gastroduodenal lesions after radioembolization of hepatic tumors.
abstract: OBJECTIVE
  To evaluate the long-term natural history of the gastroduodenal lesions secondary to extrahepatic embolization with Ytrium 90 (⁹⁰Y) spheres.
  
  
  METHODS
  From September 2003 to January 2012, 379 procedures of liver radioembolization (RE) using resin microspheres loaded with ⁹⁰Y were performed in our center. We have retrospectively compiled the data from 379 RE procedures performed in our center. We report a comprehensive clinical, analytical, endoscopic and histologic long-term follow-up of a series of patients who developed gastroduodenal lesions after the treatment.
  
  
  RESULTS
  Six patients (1.5%) developed gastrointestinal symptoms and had gastrointestinal lesions as shown by upper endoscopy in the next 12 wk after RE. The mean time between RE and the appearance of symptoms was 5 wk. Only one patient required endoscopic and surgical treatment. The incidence of gastrointestinal ulcerations was 3.75% (3/80) when only planar images were used for the pre-treatment evaluation. It was reduced to 1% (3/299) when single-photon emission computed tomography (SPECT) images were also performed. The symptoms that lasted for a longer time were nausea and vomiting, until 25 mo after the treatment.
  
  
  CONCLUSIONS
  All patients were free from severe symptoms at the end of follow-up. The routine use of SPECT has decreased the incidence of gastrointestinal lesions due to unintended deployment of ⁹⁰Y particles.
authors.affiliation: Endoscopy Unit, Department of Gastroenterology, University of Navarra Clinic, 31008 Pamplona, Navarra, Spain.
authors.forename: Iago
authors.initials: I
authors.lastname: Rodríguez-Lago
authors.forename: Cristina
authors.initials: C
authors.lastname: Carretero
authors.forename: Maite
authors.initials: M
authors.lastname: Herráiz
authors.forename: José C
authors.initials: JC
authors.lastname: Subtil
authors.forename: Maite
authors.initials: M
authors.lastname: Betés
authors.forename: Macarena
authors.initials: M
authors.lastname: Rodríguez-Fraile
authors.forename: Jesús J
authors.initials: JJ
authors.lastname: Sola
authors.forename: José I
authors.initials: JI
authors.lastname: Bilbao
authors.forename: Miguel
authors.initials: M
authors.lastname: Muñoz-Navas
authors.forename: Bruno
authors.initials: B
authors.lastname: Sangro
mesh_terms: D000328:Adult; D000368:Aged; D016461:Chemoembolization, Therapeutic / Q000009:adverse effects*; D004381:Duodenal Ulcer / Q000209:etiology* / Q000473:pathology / Q000517:prevention & control; D016099:Endoscopy, Gastrointestinal; D005500:Follow-Up Studies; D006801:Humans; D008113:Liver Neoplasms / Q000098:blood supply / Q000532:radiotherapy*; D008863:Microspheres; D008875:Middle Aged; D011832:Radiation Injuries / Q000209:etiology* / Q000473:pathology / Q000517:prevention & control; D019275:Radiopharmaceuticals / Q000008:administration & dosage / Q000009:adverse effects*; D012189:Retrospective Studies; D012307:Risk Factors; D013276:Stomach Ulcer / Q000209:etiology* / Q000473:pathology / Q000517:prevention & control; D013997:Time Factors; D015899:Tomography, Emission-Computed, Single-Photon; D016896:Treatment Outcome; D015021:Yttrium Radioisotopes / Q000008:administration & dosage / Q000009:adverse effects*
chemical_list: D019275:Radiopharmaceuticals; D015021:Yttrium Radioisotopes
keywords: Gastroduodenal ulcer; Liver; Liver neoplasms; Radioembolization; Single-photon emission computed tomography