Avtor/Urednik		Karunanithy, Narayan; Gordon, Fabiana; Hodolič, Marina; Al-Nahhas, Adil
Naslov		Embolization of hepatic arterial branches to simplify hepatic blood flow before yttrium 90 radioembolization: a useful technique in the presence of challenging anatomy
Tip		članek
Vir		Cardiovasc Intervent Radiol
Vol. in št.		Letnik 34, št. 2
Leto izdaje		2011
Obseg		str. 287-94
Jezik		eng
Abstrakt		Purpose: In the presence of variant hepatic arterial anatomy, obtaining whole-liver coverage with yttrium 90 (Y90) radioembolization may be challenging. The purpose of this study was to determine whether a technique whereby variant hepatic arterial branches are embolized and then Y90 is administered selectively into one remaining hepatic arterial branch results in whole-liver coverage and effective therapy. A retrospective comparison of treatment response was made between a group of patients who underwent this technique before Y90 administration and a group of patients who received standard Y90 administration as a single dose into the proper hepatic artery or in divided doses into the immediate hepatic artery branches. The rest of the workup and treatment were identical in both groups, including routine embolization of potential nonhepatic, nontarget vessels (e.g., the gastroduodenal artery). Methods: A total of 32 patients (mean age 56.9 years, range 39-77 years) treated with Y90 between June 2004 and March 2008 were analyzed. The primary malignancy was colorectal in 29, breast in 2, and cholangiocarcinoma in 1. Group 1 comprised 20 patients who had no alterations to their hepatic arterial supply. Group 2 comprised 12 cases who had undergone prior embolization of hepatic arterial branches before administration of Y90. The response to treatment was assessed by comparing standardized uptake value (SUV) on the pre- and postprocedure fludeoxyglucose positron emission tomographic studies of representative lesions within the right and left lobes of the liver. Results: In group 1, significant response (P < 0.001) was seen among right lobe lesions but not among left lobe lesions (P = 0.549). In group 2, there was a significant response among both right (P = 0.028) and left (P = 0.014) lobe lesions. No difference was found in the response of right lobe lesions (P = 0. (Abstract truncated at 2000 characters)
Deskriptorji		LIVER NEOPLASMS HEPATIC ARTERY BLOOD FLOW VELOCITY YTTRIUM RADIOISOTOPES EMBOLIZATION, THERAPEUTIC TOMOGRAPHY, EMISSION-COMPUTED