Interventional nuclear medicine in hepatocellular carcinoma and other tumours

The range of cancers which can be successfully treated by radioisotopes can be expanded by the use of combined pharmacological and physical targeting of the relevant radioisotope. This has been used extensively in the management of hepatocellular cancer (HCC) which has been treated with (131)I iodized poppy seed oil (Lipiodol) or (90)Y labelled glass microspheres infused into the liver under radiological control via a catheter placed into the right or left hepatic artery. In the treatment of extensive disease survival may not be changed but there is an improved quality of life after treatment. If given in the adjuvant setting, improved survival has been noted. These techniques have now been applied to other tracers for example in the use of (131)I-mIBG in treatment of rare tumours where concise localization and destruction of tumours in vital structures needs to occur without the risk of damage to surrounding tissues.