CC BY-NC-ND 4.0 · The Arab Journal of Interventional Radiology 2018; 02(03): S5-S6
DOI: 10.1055/s-0041-1730660
Abstract

Planning for Yttrium-90 Selective Internal Radiation Therapy: A Primer

Omar Bashir
King Abdulaziz Medical City, Riyadh, Saudi Arabia
,
Mohammed Arabi
King Abdulaziz Medical City, Riyadh, Saudi Arabia
,
Shahbaz Qazi
King Abdulaziz Medical City, Riyadh, Saudi Arabia
,
Yousof Al Zahrani
King Abdulaziz Medical City, Riyadh, Saudi Arabia
,
Muhammad Almoaiqel
King Abdulaziz Medical City, Riyadh, Saudi Arabia
,
Refaat Salman
King Abdulaziz Medical City, Riyadh, Saudi Arabia
› Author Affiliations

Background: Hepatocellular carcinoma (HCC) is one of the leading causes of cancer deaths worldwide. Yttirium-90 selective internal radiation therapy (Y-90 SIRT) has emerged as an effective treatment option for patients with intermediate and advanced HCC. The procedure involves delivery of glass or resin particles loaded with Y-90 into hepatic arteries supplying HCC. While a high radiation dose is delivered to the hepatic tumor, the adjacent hepatic parenchyma which is supplied preferentially by the portal vein is spared. Methods: In this educational presentation, we aim to simplify the otherwise complex multistep process undertaken before Y-90 SIRT. Results: While the SIRT procedure is based on a simple concept, it requires accurate and safe delivery of highly toxic doses of radiation into the tumor. Without proper planning, there is a high risk of undertreating HCC as well as causing significant complications from nontarget radiation injury. Based on our experience with Y90-SIRT, we present illustrated cases to give readers an overview of steps involved before SIRT. These include appropriate patient selection, careful angiographic mapping of the tumor, lung-shunt detection, and dose calculation. Conclusion: SIRT planning is a complex multistep process that requires a multidisciplinary approach to patient care, meticulous mapping angiography, and dose calculation to get the best results when treating HCCs.



Publication History

Article published online:
11 May 2021

© 2018. The Arab Journal of Interventional Radiology. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial-License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/).

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