Nuclear Medicine Procedures for Treatment Evaluation and Administration
- Arbizu, Javier 1
- Rodriguez-Fraile, Macarena 1
- Martí-Climent, Josep M 1
- Domínguez-Prado, Inés 1
- Vigil, Carmen 1
-
1
Clínica Universitaria de Navarra
info
Editorial: Springer-Verlag
ISSN: 0942-5373, 2197-4187
ISBN: 9783642364723, 9783642364730
Ano de publicación: 2014
Páxinas: 63-75
Tipo: Capítulo de libro
Resumo
The 90Yttrium radioembolisation (RE) procedure requires the collaboration of a multidisciplinary team that includes hepatologists, oncologists, interventional radiologists and nuclear medicine specialists working together in close collaboration. To avoid toxicity to the patient, a thorough angiographic evaluation is performed to identify extrahepatic vessels that may feed the tumours (to guarantee efficacy). To mimic the microsphere application during the treatment, angiographic evaluation is accomplished with 99mTechnetium-labelled macroaggregated albumin injection into the vessel of interest, followed by imaging. Both procedures combined are essential to plan the RE therapy, and to detect and eventually occlude every collateral vessel arising from a hepatic artery that may carry microspheres to the gastrointestinal tract or other extrahepatic organs. Moreover, this approach permits the calculation of hepatopulmonary shunting, and tumour and liver tissue targeting. With this information taken together, the treatment is designed and activity is calculated to maximise the dose of radiation delivered to liver tumours while safely preserving the non-tumoural parenchyma.
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