Hybrid angiography-CT for transarterial radioembolization: a pictorial essay

Lionberg, Alex; Nijhawan, Karan; Navuluri, Rakesh; Zangan, Steven; Ha, Thuong Van; Funaki, Brian; Ahmed, Osman

doi:10.1007/s00261-020-02914-8

Cited by 11 publications

(5 citation statements)

References 8 publications

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“…Once introduced, y90 undergoes beta-radiation decay and induces cellular damage as well as local tumor-cellular DNA damage culminating in cell death [13]. When available, hybrid CT-angiography can be used to delineate the hepatic vascular anatomy for precise y90 delivery [14]. Lastly, y90 delivery has been used to consolidate disease prior to limited hepatectomy in some cases with considerable success [15].…”

Section: Liver Directed Therapymentioning

confidence: 99%

Treatment of metastatic uveal melanoma in 2022: improved treatment regimens and improved prognosis

Reichstein

Brock

Lietman

et al. 2022

Current Opinion in Ophthalmology

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Purpose of reviewUntil recently, metastatic uveal melanoma was associated with essentially uniform fatality within months. However, recent developments in screening, improved understanding of the genetic underpinnings of metastatic disease, and pivotal medication approvals have improved the disease's rate of fatality. Recent findingsRoutine implementation of genetic testing at the time of primary tumor treatment via gene expression profiling or chromosomal analysis has identified patients who are at high risk for metastatic disease. Enhanced screening with imaging directed at the liver and lungs has allowed for identification of early disease and lower tumor burden. Significant work on improved liver directed therapy along with systemic chemotherapy and immunotherapy has improved life expectancy. The first systemic immunotherapy specifically for metastatic uveal melanoma was approved this year. This medication, tebentafusp, is likely to improve life expectancy for all patients with metastatic melanoma assuming they have appropriate human leukocyte antigen (HLA) markers. Multiple clinical trials with novel immunotherapeutic agents are promising as well.

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Section: Liver Directed Therapymentioning

confidence: 99%

Treatment of metastatic uveal melanoma in 2022: improved treatment regimens and improved prognosis

Reichstein

Brock

Lietman

et al. 2022

Current Opinion in Ophthalmology

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“…The combination of an accurate vascular anatomy and perfused-liver volume calculation for dosimetry provides a significant added value in transarterial radioembolization, where non-target embolization would have severe consequences [ 82 ]. CTA can also be repeated during or immediately after the procedure to assess the technical success, the complications, and, eventually, refine the results of the treatment.…”

Section: Imaging Modalitiesmentioning

confidence: 99%

“…When compared to cone-beam computed tomography (CBCT), CTA demonstrated lower radiation dose [ 82 , 84 , 85 ] and reduction of the contrast media administration [ 84 ]; moreover, it provides a wider field of view and less image noise [ 86 , 87 ]. However, CTA is not widely available when compared to other imaging methods; it is more expensive and requires greater room spaces.…”

Section: Imaging Modalitiesmentioning

confidence: 99%

Precision Imaging Guidance in the Era of Precision Oncology: An Update of Imaging Tools for Interventional Procedures

Floridi

Cellina

Irmici

et al. 2022

JCM

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Interventional oncology (IO) procedures have become extremely popular in interventional radiology (IR) and play an essential role in the diagnosis, treatment, and supportive care of oncologic patients through new and safe procedures. IR procedures can be divided into two main groups: vascular and non-vascular. Vascular approaches are mainly based on embolization and concomitant injection of chemotherapeutics directly into the tumor-feeding vessels. Percutaneous approaches are a type of non-vascular procedures and include percutaneous image-guided biopsies and different ablation techniques with radiofrequency, microwaves, cryoablation, and focused ultrasound. The use of these techniques requires precise imaging pretreatment planning and guidance that can be provided through different imaging techniques: ultrasound, computed tomography, cone-beam computed tomography, and magnetic resonance. These imaging modalities can be used alone or in combination, thanks to fusion imaging, to further improve the confidence of the operators and the efficacy and safety of the procedures. This article aims is to provide an overview of the available IO procedures based on clinical imaging guidance to develop a targeted and optimal approach to cancer patients.

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“…Workflow optimization in the setting of trauma and superior diagnostic imaging during hepatic radioembolization have been achieved with performing these IR procedures in a hybrid angio-CT suite. 31,32 The authors described how satellite lesions and perfused liver volumes could be more accurately assessed during mapping angiography. Similarly, automated feeder detection software has improved identification and tracking of arteries intended for embolization.…”

Section: Controversy No 2: Pae Can Be Performed Without Preprocedural...mentioning

confidence: 99%

Controversies in Prostate Artery Embolization: Future Best Practice

Goyal

Salem

Mouli

2022

Semin intervent Radiol

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Prevalence of lower urinary tract symptoms secondary to benign prostatic hyperplasia is correlated with age. Men seeking treatment options with a low side effect profile often turn to prostate artery embolization (PAE). PAE continues to be refined with advanced tools and optimized techniques. Nonetheless, there exist controversies in terms of best practices for the management of lower urinary track symptoms (LUTS) with PAE. These controversies are essential for medical progress. Herein we suggest best practices moving forward based on currently available data. Given extensive safety data, we recommend PAE be considered alongside medical management and as a precursor to surgery. Given demonstrated efficacy across gland sizes, PAE can be performed in a single session, ideally in a hybrid angio-CT suite, without preoperative cross-sectional imaging. PAE should be initially performed with 300- to 500-μm size particles, and instead consider exploring other particles and sizes for repeat PAE. Finally, PAE can also be considered as first-line option for recurrent disease given the efficacy and excellent safety profile. This article is not meant to purport a dogma, but rather to serve as a guide to the experienced practitioner in challenging his or her own biases when performing PAE.

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Hybrid angiography-CT for transarterial radioembolization: a pictorial essay

Cited by 11 publications

References 8 publications

Treatment of metastatic uveal melanoma in 2022: improved treatment regimens and improved prognosis

Treatment of metastatic uveal melanoma in 2022: improved treatment regimens and improved prognosis

Precision Imaging Guidance in the Era of Precision Oncology: An Update of Imaging Tools for Interventional Procedures

Controversies in Prostate Artery Embolization: Future Best Practice

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