Abstract
Radioembolization with yttrium-90 resin microspheres is a treatment option that selectively targets hepatic tumors. One of the primary limiting factors for this therapy is the degree of arteriohepatovenous shunting, as excessive radiation to the lungs may cause radiation pneumonitis. To safeguard patients against this, a technetium Tc 99m macroaggregated albumin scan is performed before treatment to assess the degree of arteriohepatovenous shunting. As lung shunt fraction increases, activity reductions are mandated, with a 20% shunt sufficient to prohibit treatment. Temporary occlusion of shunts may be achieved by placement of balloon catheters in the hepatic veins. This endovascular technique used to reduce arteriohepatovenous shunting allows otherwise untreatable patients to undergo radioembolization.
MeSH terms
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Balloon Occlusion / methods*
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Feasibility Studies
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Female
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Hepatic Veins / diagnostic imaging
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Hepatic Veins / physiopathology*
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Humans
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Liver / blood supply*
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Liver / diagnostic imaging
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Liver Circulation*
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Liver Neoplasms / blood supply
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Liver Neoplasms / diagnostic imaging
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Liver Neoplasms / radiotherapy*
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Lung / blood supply*
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Lung / diagnostic imaging
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Lung / radiation effects
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Male
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Microspheres*
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Middle Aged
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Pulmonary Circulation
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Radiation Pneumonitis / etiology
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Radiation Pneumonitis / physiopathology
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Radiation Pneumonitis / prevention & control*
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Radiography
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Radiopharmaceuticals
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Technetium Tc 99m Aggregated Albumin
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Tomography, Emission-Computed, Single-Photon / methods
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Yttrium Radioisotopes / administration & dosage
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Yttrium Radioisotopes / adverse effects*
Substances
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Radiopharmaceuticals
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Technetium Tc 99m Aggregated Albumin
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Yttrium Radioisotopes