Abstract
Purpose: To evaluate the impact of identifiable hepatic vein tumor thrombus on the ability to safely deliver TheraSphere (yttrium 90-containing glass microspheres) for the treatment of hepatocellular carcinoma (HCC). Materials and Methods: A retrospective review was performed of 87 patients (71 men, 16 women; mean age, 64.5 years; age range, 25-83 y) referred for TheraSphere therapy for HCC during a 2-year period between April 2005 and May 2007. Evaluation included contrast-enhanced computed tomography or magnetic resonance imaging, selective mesenteric angiography, and radionuclide perfusion scintigraphy to measure the arteriovenous shunting through the tumor. Results: Of the 87 patients, 83 underwent angiography and perfusion scintigraphy; 53 were ultimately treated with 65 glass microsphere infusions. Twelve of 83 were identified as having tumor thrombus in a hepatic vein or extending into the inferior vena cava. The mean lung shunt for the patients with hepatic vein tumor thrombus was 30% (range, 11%-60%), compared with 8.2% (range, 3%-23%) for patients without identifiable tumor thrombus. Two of the 12 patients were treated with reduced doses of glass microspheres, and the remaining 10 were offered alternative therapies. Conclusions: The presence of hepatic vein tumor thrombus is a risk factor for an increased lung shunt that may prohibit delivery of a therapeutic dose of TheraSphere to hepatic tumor.
| Original language | English (US) |
|---|---|
| Pages (from-to) | 1460-1463 |
| Number of pages | 4 |
| Journal | Journal of Vascular and Interventional Radiology |
| Volume | 20 |
| Issue number | 11 |
| DOIs | |
| State | Published - Nov 2009 |
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ASJC Scopus subject areas
- Radiology Nuclear Medicine and imaging
- Cardiology and Cardiovascular Medicine
Cite this
Hepatic Vein Tumor Thrombus as a Risk Factor for Excessive Pulmonary Deposition of Microspheres during TheraSphere Therapy for Unresectable Hepatocellular Carcinoma. / Fleming, Chad J.; Andrews, James C.; Wiseman, Gregory A.; Gansen, Denise N.; Roberts, Lewis Rowland.
In: Journal of Vascular and Interventional Radiology, Vol. 20, No. 11, 11.2009, p. 1460-1463.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Hepatic Vein Tumor Thrombus as a Risk Factor for Excessive Pulmonary Deposition of Microspheres during TheraSphere Therapy for Unresectable Hepatocellular Carcinoma
AU - Fleming, Chad J.
AU - Andrews, James C.
AU - Wiseman, Gregory A.
AU - Gansen, Denise N.
AU - Roberts, Lewis Rowland
PY - 2009/11
Y1 - 2009/11
N2 - Purpose: To evaluate the impact of identifiable hepatic vein tumor thrombus on the ability to safely deliver TheraSphere (yttrium 90-containing glass microspheres) for the treatment of hepatocellular carcinoma (HCC). Materials and Methods: A retrospective review was performed of 87 patients (71 men, 16 women; mean age, 64.5 years; age range, 25-83 y) referred for TheraSphere therapy for HCC during a 2-year period between April 2005 and May 2007. Evaluation included contrast-enhanced computed tomography or magnetic resonance imaging, selective mesenteric angiography, and radionuclide perfusion scintigraphy to measure the arteriovenous shunting through the tumor. Results: Of the 87 patients, 83 underwent angiography and perfusion scintigraphy; 53 were ultimately treated with 65 glass microsphere infusions. Twelve of 83 were identified as having tumor thrombus in a hepatic vein or extending into the inferior vena cava. The mean lung shunt for the patients with hepatic vein tumor thrombus was 30% (range, 11%-60%), compared with 8.2% (range, 3%-23%) for patients without identifiable tumor thrombus. Two of the 12 patients were treated with reduced doses of glass microspheres, and the remaining 10 were offered alternative therapies. Conclusions: The presence of hepatic vein tumor thrombus is a risk factor for an increased lung shunt that may prohibit delivery of a therapeutic dose of TheraSphere to hepatic tumor.
AB - Purpose: To evaluate the impact of identifiable hepatic vein tumor thrombus on the ability to safely deliver TheraSphere (yttrium 90-containing glass microspheres) for the treatment of hepatocellular carcinoma (HCC). Materials and Methods: A retrospective review was performed of 87 patients (71 men, 16 women; mean age, 64.5 years; age range, 25-83 y) referred for TheraSphere therapy for HCC during a 2-year period between April 2005 and May 2007. Evaluation included contrast-enhanced computed tomography or magnetic resonance imaging, selective mesenteric angiography, and radionuclide perfusion scintigraphy to measure the arteriovenous shunting through the tumor. Results: Of the 87 patients, 83 underwent angiography and perfusion scintigraphy; 53 were ultimately treated with 65 glass microsphere infusions. Twelve of 83 were identified as having tumor thrombus in a hepatic vein or extending into the inferior vena cava. The mean lung shunt for the patients with hepatic vein tumor thrombus was 30% (range, 11%-60%), compared with 8.2% (range, 3%-23%) for patients without identifiable tumor thrombus. Two of the 12 patients were treated with reduced doses of glass microspheres, and the remaining 10 were offered alternative therapies. Conclusions: The presence of hepatic vein tumor thrombus is a risk factor for an increased lung shunt that may prohibit delivery of a therapeutic dose of TheraSphere to hepatic tumor.
UR - http://www.scopus.com/inward/record.url?scp=70350513596&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=70350513596&partnerID=8YFLogxK
U2 - 10.1016/j.jvir.2009.07.033
DO - 10.1016/j.jvir.2009.07.033
M3 - Article
C2 - 19875064
AN - SCOPUS:70350513596
VL - 20
SP - 1460
EP - 1463
JO - Journal of Vascular and Interventional Radiology
JF - Journal of Vascular and Interventional Radiology
SN - 1051-0443
IS - 11
ER -