Radioembolization with yttrium-90 microspheres work up: Practical approach and literature review.
Radioembolization (RE) is a selective internal radiotherapy technique in which yttrium-90 blended microspheres are infused through the hepatic arteries. It is based on the fact that primary and secondary hepatic tumors are vascularized mostly by arterial blood flow whereas healthy hepatocytes obtain their blood supply mostly from the portal network. This enables high radiation doses to be delivered, sparing the surrounding non-malignant liver parenchyma. Most of the complications are caused by unexpected particles passing into the gastrointestinal tract through branches originating from the main hepatic arterial supply. Knowledge of this hepatic arterial network and of its variations and the technical considerations this raises are required in preparation for treatment. This work describes the specific anatomical features and techniques for this anatomy through recent literature illustrated by cases from our own experience.
Functional and Therapeutic Diagnostic Imaging Unit, Poitiers University Hospital, rue de la Milétrie, 86000 Poitiers, France. Electronic address: guillaumevesselle@gmail.com.
G
G
Vesselle
Functional and Therapeutic Diagnostic Imaging Unit, Poitiers University Hospital, rue de la Milétrie, 86000 Poitiers, France.
I
I
Petit
Functional and Therapeutic Diagnostic Imaging Unit, Poitiers University Hospital, rue de la Milétrie, 86000 Poitiers, France.
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S
Boucebci
Functional and Therapeutic Diagnostic Imaging Unit, Poitiers University Hospital, rue de la Milétrie, 86000 Poitiers, France.
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T
Rocher
Functional and Therapeutic Diagnostic Imaging Unit, Poitiers University Hospital, rue de la Milétrie, 86000 Poitiers, France.
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S
Velasco
Functional and Therapeutic Diagnostic Imaging Unit, Poitiers University Hospital, rue de la Milétrie, 86000 Poitiers, France.
J-P
JP
Tasu
D063405:Anatomic Variation; D004621:Embolization, Therapeutic / Q000379:methods*; D006499:Hepatic Artery / Q000033:anatomy & histology / Q000000981:diagnostic imaging; D006801:Humans; D008099:Liver / Q000098:blood supply / Q000000981:diagnostic imaging; D008113:Liver Neoplasms / Q000098:blood supply / Q000532:radiotherapy*; D008863:Microspheres; D011859:Radiography; D015021:Yttrium Radioisotopes / Q000627:therapeutic use*
D015021:Yttrium Radioisotopes
Hepatocellular carcinoma; Interventional oncology; Radioembolization; Selective internal radiotherapy; Yttrium-90