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90Y Resin Microspheres Radioembolization for Colon Cancer Liver Metastases Using Full-Strength Contrast Material.

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This study found that using undiluted non-ionic contrast material (UDCM) for Yttrium-90 (90Y) resin microsphere radioembolization is safe and effective. This method reduces radiation dose and infusion time without increasing complications like myelosuppression.

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Area of Science:

  • Interventional Radiology
  • Nuclear Medicine
  • Oncology

Background:

  • Radioembolization (RAE) with 90Y resin microspheres is a standard treatment for liver metastases.
  • Traditional RAE uses a 'sandwich' infusion technique.
  • Optimizing RAE delivery is crucial for patient safety and treatment efficacy.

Purpose of the Study:

  • To evaluate the safety and efficacy of using undiluted non-ionic contrast material (UDCM) for 90Y resin microsphere administration.
  • To compare outcomes between UDCM (study group) and standard sandwich infusion (control group) in patients with colorectal cancer liver metastases.

Main Methods:

  • Retrospective review of patients treated with 90Y resin microsphere RAE from 2009 to 2017.
  • UDCM was used by two operators from April 2013 onwards (study group).
  • Outcomes assessed included myelosuppression, stasis, non-target delivery (NTD), fluoroscopy radiation dose (FRD), infusion time (IT), liver progression-free survival (LPFS), and overall survival (OS).

Main Results:

  • No significant difference in myelosuppression or Grade 1-4 toxicities between UDCM and control groups.
  • UDCM group showed significantly lower median FRD (44.6 vs. 97.35 Gy/cm2) and IT (31 vs. 39 min).
  • No significant difference in stasis incidence, NTD, LPFS, or OS between groups.

Conclusions:

  • Administration of 90Y resin microspheres using UDCM is safe and effective for liver metastases.
  • UDCM use leads to reduced fluoroscopy radiation dose and shorter infusion times.
  • This technique does not increase the incidence of myelosuppression or stasis.