Same-day ⁹⁰Y radioembolization: implementing a new treatment paradigm

Area of Science:

• Interventional Radiology
• Nuclear Medicine
• Oncology

Background:

• Liver cancer treatment often involves multiple appointments.
• Radioembolization is a targeted therapy for liver tumors.

Purpose of the Study:

• To assess the feasibility of a same-day outpatient procedure combining mesenteric angiography, coil embolization, technetium-99m macroaggregated albumin (99mTc-MAA) scintigraphy, and yttrium-90 (90Y) radioembolization.
• To evaluate the safety and efficiency of this integrated approach.

Main Methods:

• Retrospective analysis of 78 patients undergoing same-day procedures.
• Pretreatment planning included imaging, perfused liver volume estimation, and dosimetry.
• Procedures involved hepatic angiography, 99mTc-MAA scintigraphy, and 90Y radioembolization in one encounter.

Main Results:

• All 78 patients successfully completed the same-day angiography, scintigraphy, and 90Y radioembolization.
• Median treatment dose was 106 Gy, with a median of two 90Y vials used.
• Median in-room procedure time was 160 minutes, demonstrating efficient workflow.

Conclusions:

• Same-day 90Y radioembolization evaluation and treatment is feasible.
• This integrated approach maintains safety and efficacy, ensuring tumoricidal dosimetry and minimizing non-target doses.
• The paradigm offers expedited cancer care and significant cost savings for patients.