Yttrium-90 hepatic radioembolization in Hybrid Suites, Miyabi Angio-CT: role of the Radiographer and current techniques in Interventional and Medical Oncology Unit

Congress:

ECR 2020

Poster Number:

C-05752

Type:

Scientific Exhibit

Keywords:

Performed at one institution, Not applicable, Neoplasia, Multidisciplinary cancer care, Cancer, Radionuclide therapy, Radioembolisation, Brachytherapy, PET-CT, Image manipulation / Reconstruction, CT-Angiography, Liver, Interventional vascular, Hybrid Imaging, Interventional Radiography

Authors:

P. Molinari¹, G. Falagario¹, V. BUONO¹, F. De Filippis¹, M. Carlucci¹, C. D. Gadaleta¹, G. Ranieri¹, G. MASTRANDREA¹, G. C. Laricchia²; ¹BARI/IT, ²Bari, Bari/IT

DOI:

10.26044/ecr2020/C-05752

DOI-Link:

https://dx.doi.org/10.26044/ecr2020/C-05752

Fig. 4: Interventional and Medical Oncology Unit

Fig. 1: Hybrid Suites, Miyabi Angio-CT

Fig. 2: Yttrium-90 hepatic radioembolization

Fig. 3: Hybrid Imaging

Purpose

Our study describes the performance of Yttrium-90 radioembolization (90Y-RE) for the treatment of hepatocellular carcinoma (HCC) and liver metastases, focusing on the safety and results of treatment in selected patients under general anesthesia. Safety and technical-methodological aspects were evaluated, underlining the role of Radiographer in a hybrid operating/interventional room equipped with Angiography and CT scanning capability, so-called MIYABI Angio-CT. We practice this technique using a multidisciplinary teamwork made up of interventional radiologist, physicist, oncologist, internist, nuclear medicine physician, anesthesiologist, Radiographer and a nursing supervisor. This...

Methods and materials

90Y-RE is a minimally invasive procedure similar to chemoembolization that uses radiolabeled glass or resin beads to kill tumor cells while sparing healthy liver tissue. Percutaneous treatment is performed under the guidance of Angio-CT System, ensuring safety and accuracy of target treatment. We need a still and painless patient. Than we use preemptive analgesia and general anesthesia with IV drug for induction, inhaled and IV agent for maintenance and neuromuscular junction blockers to cause muscle relaxation. So patient selected during SIRTeam normally arrives in the...

Results

More of 90 properly selected patients were treated in our department in a time period of 3 years. Data from our study confirmed the saftey of 90Y-RE technique with low complication rates and importance of a strict protocol toselect and follow-up patients and to organize multidisciplinary research activities.This is the first experience in Southern Italy.

Conclusion

Interventional Oncology demonstrates its importance in the most complete and detailed way with implantation of radioactive substances inside the liver for the treatment of primary and secondary tumors. We are referring to the technique of radioembolization and its hybrid nature, being a multimodal and multidisciplinary procedure used especially in association with another technologies. Radiographer is an essential part of Team to delivering hybrid imaging that allow interventional oncological procedures to be precisely conducted.

Personal information and conflict of interest

P. Molinari; Bari/IT - nothing to disclose G. Falagario; Bari/IT - nothing to disclose G. C. Laricchia; Bari, BARI/IT - nothing to disclose C. D. Gadaleta; Bari, BARI/IT - nothing to disclose V. Buono; Bari/IT - nothing to disclose G. Ranieri; Bari/IT - nothing to disclose G. Mastrandrea; Bari, BARI/IT - nothing to disclose F. de Filippis; Bari/IT - nothing to disclose M. Carlucci; Bari/IT - nothing to disclose

References

Salem R,PadiaSA et al.Clinical anddosimetricconsiderations for Y90:recommendations froman international multidisciplinary workinggroup.EurJNuclMedMolImaging. 2019; Feng-YongLiu,XinLi et al. Angio-ComputedTomograph-GuidedImmediateLipiodolComputedTomographforDiagnosisofSmall HepatocellularCarcinomaLesionsduringTransarterialChemoembolization.ChinMedJ. 2018 ; https://www.aitri.it/radioembolizzazione-epatica-il-ruolo-del-tsrm-nelloncologia-interventistica (website)