Radioembolization

>190-200 Gy dose predicts complete pathological response.

Theraspheres vs SIRspheres[1]
FDA Approved for Material composition Particle size Activity per microsphere Microspheres per vial Embolic effect Technical considerations
Theraspheres Unresectable HCC Insoluble glass microspheres with Y-90 an integral part of the glass 20-30 um 2500 bq 1.2 to 8 million depending on activity size ordered +

(non-occlusive)

130cm microcatheter
SIRspheres Unresectable liver metastases from colorectal cancer Biocompatible resin containing Y-90 20-40 um 50 bq 40-80 million ++

(may be occlusive)

Can use 110cm microcatheter

Vessel must take 2 for 8 without reflux

Cholecystitis- 0.6-2%. debate over whether prophylactic embolization is needed, even if proximal to cystic artery origin.

Supraduodenal, retrodudoenal arteries-

falcoform arteries-

Indications

  • primarily as palliative option for the treatment of 1° or 2° hepatic malignancies, when other invasive or chemotherapeutic treatments have failed [2]

References

  1. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3036309/
  2. Braat AJ, Smits ML, Braat MN, van den Hoven AF, Prince JF, de Jong HW, van den Bosch MA, Lam MG. ⁹⁰Y Hepatic Radioembolization: An Update on Current Practice and Recent Developments. (2015) Journal of nuclear medicine : official publication, Society of Nuclear Medicine. 56 (7): 1079 doi:10.2967/jnumed.115.157446 - Pubmed

Contributing Authors

BGG, Kevin Liu