title: Outpatient single-session yttrium-90 glass microsphere radioembolization.
abstract: OBJECTIVE
  To investigate the feasibility of yttrium-90 ((90)Y) glass microsphere radioembolization (including angiography, lung shunt assessment, and treatment) as a single-session, outpatient procedure.
  
  
  METHODS
  Between January 2008 and June 2013, 14 patients underwent outpatient, single-session radioembolization with (90)Y glass microspheres. As part of the routine diagnostic work-up, all patients underwent either computed tomography (CT) or magnetic resonance imaging of the liver with three-dimensional analysis and had laboratory results forwarded to our center for confirmation of candidacy before treatment. On treatment day, all patients underwent planning mesenteric angiography with flat panel cone-beam CT imaging. Patients were administered 33-85 MBq of technetium-99m macroaggregated albumin ((99m)Tc-MAA) via a microcatheter positioned in a hepatic artery supplying the tumor of interest. Planar scintigraphy was initiated within 2 hours after the administration of (99m)Tc-MAA and lung shunt fraction was determined. Final dosimetry calculations were performed while the patient was being transferred back from nuclear medicine to interventional radiology.
  
  
  RESULTS
  All patients successfully underwent planning angiography with administration of (99m)Tc-MAA and (90)Y radioembolization as a single-session treatment. There were no reportable or recordable medical events; treatment was carried out to the desired dose in all cases. The mean total procedure time was 2.70 hours ± 0.72 (range, 1.63-3.97 h).
  
  
  CONCLUSIONS
  This study reports a novel proof of concept for performing radioembolization in a single-session setting. By using the described method, time between initial clinical assessments and radioembolization treatment is decreased, and costs are minimized.
authors: Department of Radiology, Section of Nuclear Medicine, Robert H. Lurie Comprehensive Cancer Center, Northwestern University, 676 North St Clair, Suite 800, Chicago, IL 60611.
authors: Vanessa L
authors: VL
authors: Gates
authors: Section of Interventional Radiology, Robert H. Lurie Comprehensive Cancer Center, Northwestern University, 676 North St Clair, Suite 800, Chicago, IL 60611.
authors: Karen G
authors: KG
authors: Marshall
authors: Section of Interventional Radiology, Robert H. Lurie Comprehensive Cancer Center, Northwestern University, 676 North St Clair, Suite 800, Chicago, IL 60611.
authors: Krystina
authors: K
authors: Salzig
authors: Section of Interventional Radiology, Robert H. Lurie Comprehensive Cancer Center, Northwestern University, 676 North St Clair, Suite 800, Chicago, IL 60611.
authors: Melissa
authors: M
authors: Williams
authors: Section of Interventional Radiology, Robert H. Lurie Comprehensive Cancer Center, Northwestern University, 676 North St Clair, Suite 800, Chicago, IL 60611.
authors: Robert J
authors: RJ
authors: Lewandowski
authors: Section of Interventional Radiology, Robert H. Lurie Comprehensive Cancer Center, Northwestern University, 676 North St Clair, Suite 800, Chicago, IL 60611. Electronic address: r-salem@northwestern.edu.
authors: Riad
authors: R
authors: Salem
mesh_terms: D000553:Ambulatory Care; D015901:Angiography, Digital Subtraction; D004621:Embolization, Therapeutic / Q000009:adverse effects / Q000379:methods*; D005240:Feasibility Studies; D005898:Glass; D006801:Humans; D008113:Liver Neoplasms / Q000098:blood supply / Q000473:pathology / Q000532:radiotherapy*; D008279:Magnetic Resonance Imaging; D008863:Microspheres; D015641:Radiography, Interventional; D019275:Radiopharmaceuticals / Q000008:administration & dosage*; D013668:Technetium Tc 99m Aggregated Albumin; D013997:Time Factors; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D015021:Yttrium Radioisotopes / Q000008:administration & dosage*
chemical_list: D019275:Radiopharmaceuticals; D013668:Technetium Tc 99m Aggregated Albumin; D015021:Yttrium Radioisotopes
keywords: (90)Y; (99m)Tc-MAA; DSA; LSF; MIRD; SPECT; digital subtraction angiography; lung shunt fraction; medical internal radiation dose; single photon emission computed tomography; technetium-99m macroaggregated albumin; yttrium-90