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Patient Selection and Clinical Outcomes of Y90 in Hepatocellular Carcinoma
Y90 radioembolization is an alternative to transarterial chemoembolization for the intra-arterial treatment of hepatocellular carcinoma (HCC). However, the optimal treatment of HCC varies by tumor stage, underlying liver function and functional status, and local expertise. Therefore, the appropriate selection of patients for Y90 radioembolization is of paramount importance for optimal outcomes. Data on the role of Y90 radioembolization for HCC are most robust in the palliative treatment of inoperable, liver-confined disease. (Source: Techniques in Vascular and Interventional Radiology)
Source: Techniques in Vascular and Interventional Radiology - March 14, 2019 Category: Radiology Authors: Eric Wehrenberg-Klee, Ripal T. Gandhi, Suvranu Ganguli Source Type: research

Yttrium-90 Complications: Prevention and Management
Radioembolization has become a more prevalent treatment for both primary and secondary liver of the liver. Radioembolization is a relatively safe procedure with major complications being rare. Understanding how to identify the potential complications and their treatment can help make the procedure even safer and mitigate the risk of severe life threatening complications. In this article, we will review the most common complications, how to identify them, and how manage them. (Source: Techniques in Vascular and Interventional Radiology)
Source: Techniques in Vascular and Interventional Radiology - March 14, 2019 Category: Radiology Authors: Joseph J. Titano, Edward Kim, Rahul S. Patel Source Type: research

Evidence-Based Integration of Yttrium-90 Radioembolization in the Contemporary Management of Hepatic Metastases from Colorectal Cancer
Hepatic metastases are common in patients with metastatic colorectal cancer and are frequently the most life-threatening source of morbidity and mortality. The contemporary management of patients with liver-dominant or liver-only metastatic colorectal cancer is characterized by resection of metastases when feasible and successive lines of systemic treatment regimens consisting of chemotherapy drugs and/or targeted biological agents. Yttrium-90 radioembolization has emerged as a promising liver-directed therapy for patients with unresectable colorectal cancer liver metastases (CLM). (Source: Techniques in Vascular and Interventional Radiology)
Source: Techniques in Vascular and Interventional Radiology - March 13, 2019 Category: Radiology Authors: David S. Wang, John D. Louie, Daniel Y. Sze Source Type: research

Y90 Clinical Data Update: Cholangiocarcinoma, Neuroendocrine Tumor, Melanoma, and Breast Cancer Metastatic Disease
While the most compelling levels of evidence for the use of Yttrium-90 (90Y) radioembolization are in patients with hepatocellular carcinoma and hepatic metastases from colorectal cancer, a growing body of literature supports its use in other primary and secondary hepatic malignancies. This includes intrahepatic cholangiocarcinoma, as well as hepatic metastases from neuroendocrine cancer, ocular melanoma, and breast cancer. While is it not feasible to conduct prospective, randomized trials for radioembolization in the setting of these malignancies due to the low overall prevalence of liver-only disease, numerous single-arm...
Source: Techniques in Vascular and Interventional Radiology - March 10, 2019 Category: Radiology Authors: Siddharth A. Padia Source Type: research

Introduction to Issue on Yttrium-90 Radioembolization
Interventional oncology (IO) has developed into a subspecialty within interventional radiology and is evolving into the fourth pillar of cancer care in conjunction with medical, surgical, and radiation oncology. Interventional oncology is one of the most exciting and growing areas in minimally invasive interventions with the advent of innovative therapeutic platforms and dedicated devices. Yttrium-90 radioembolization, also known as selective internal radiation therapy or simply Y90, has become established as a very important therapeutic modality in the armamentarium of the interventional oncologist. (Source: Techniques in...
Source: Techniques in Vascular and Interventional Radiology - March 7, 2019 Category: Radiology Authors: Ripal Gandhi Source Type: research

Red Flags, Pitfalls, and Cautions in Y90 Radiotherapy
This article reviews common scenarios that can present in daily practice including evaluation of liver functions, evaluation of previous therapies, integrating Y90 into ongoing systemic therapy, determining performance status, and considering retreatment for patients who have already undergone Y90 who have hepatic dominant progression. (Source: Techniques in Vascular and Interventional Radiology)
Source: Techniques in Vascular and Interventional Radiology - March 7, 2019 Category: Radiology Authors: Sergio Klimkowski, Jennifer C. Baker, Daniel B. Brown Source Type: research

Technical Aspects and Practical Approach Toward Same-Day Y90 Radioembolization in the Management of Hepatocellular Carcinoma
Radioembolization with Yttrium-90 (Y90) has been proven safe and effective for the treatment of primary and secondary hepatic malignancies. Standard protocols have necessitated planning angiography with Technetium-99m macroaggregated albumin (Tc99m MAA) administration/scan typically 1-2 weeks prior to the radioembolization therapy. The intent of this practice is to ensure appropriate patient selection and treatment candidacy while also confirming best dosimetry approaches. At our center, we started performing “same-day Y90” in 2008; in a subset of international patients with travel hardship, we performed the planning a...
Source: Techniques in Vascular and Interventional Radiology - March 7, 2019 Category: Radiology Authors: Ahmed Gabr, Rehan Ali, Ali Al Asadi, Ronald Mora, Samdeep Mouli, Ahsun Riaz, Riad Salem, Robert J. Lewandowski Source Type: research

Yttrium-90 Radioembolization After Local Hepatic Therapy: How Prior Treatments Impact Patient Selection, Dosing, and Toxicity
Numerous local treatment strategies now exist for patients with primary and metastatic liver tumors. Increasingly, patients who cannot be adequately treated with a single form of focal therapy, go on to receive a variety of sequential treatments. However, the impact of each prior therapy on subsequent treatments and the cumulative toxicity of these therapies remains uncertain. Yttrium-90 radioembolization is becoming an increasingly common treatment for patients with hepatic malignancies. Though the baseline toxicity of radioembolization is low, greater care must be taken when treating patients who have undergone prior hep...
Source: Techniques in Vascular and Interventional Radiology - March 7, 2019 Category: Radiology Authors: Jonathan Kessler, John J. Park Source Type: research

FM : Editorial board - pick up from last issue
(Source: Techniques in Vascular and Interventional Radiology)
Source: Techniques in Vascular and Interventional Radiology - February 12, 2019 Category: Radiology Source Type: research

FM: Previous topics - updates
(Source: Techniques in Vascular and Interventional Radiology)
Source: Techniques in Vascular and Interventional Radiology - February 12, 2019 Category: Radiology Source Type: research

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(Source: Techniques in Vascular and Interventional Radiology)
Source: Techniques in Vascular and Interventional Radiology - February 12, 2019 Category: Radiology Source Type: research

Ablation Planning Software for Optimizing Treatment: Challenges, Techniques, and Applications
Percutaneous ablation can deliver effective anticancer therapy with minimal side effects; however, undertreatment can lead to disease recurrence and overtreatment can lead to unnecessary complications. Ablation planning software can support the procedure during the planning, treatment, and follow-up phases. In this review, 2 examples of microwave ablation software are described with attention to how the software can influence procedural choices. In the future, ablation software will entail larger source datasets and more refined algorithms to better model the in vivo ablation zone. (Source: Techniques in Vascular and Interventional Radiology)
Source: Techniques in Vascular and Interventional Radiology - December 13, 2018 Category: Radiology Authors: Gray R. Lyons, Bradley B. Pua Source Type: research

Simulation-based Training for Interventional Radiology and Opportunities for Improving the Educational Paradigm
The current model for medical education is based on the Master-Apprentice model which was adopted into practice over a century ago. Since then, there have been many changes in healthcare and the environment in which trainees learn, practice and become proficient in procedural and critical thinking skills. The current model for medical education has however, not changed considerably in this time frame, resulting in significant limitations to trainee education. Simulator-based training is a technique which can minimize the limitations of the apprenticeship model by mitigating the effect of time constraints, increased emphasi...
Source: Techniques in Vascular and Interventional Radiology - December 5, 2018 Category: Radiology Authors: Zoe A. Miller, Ayush Amin, Joanthan Tu, Ana Echenique, Ronald S. Winokur Source Type: research

Three-Dimensional Printing for Procedure Rehearsal/Simulation/Planning in Interventional Radiology
With the advances in affordable three-dimensional (3D) printing technology, 3D reconstruction and patient-specific 3D printed models are establishing a crucial role in the field of medicine for both educational purposes and procedural planning. 3D printed models provide physicians with increased 3D perception and tactile feedback, and enable a team-based approach to operational planning. However, performing an effective 3D reconstruction requires an in-depth understanding of the software features to accurately segment and reconstruct the human anatomy of interest from preacquired image data from multiple modalities such as...
Source: Techniques in Vascular and Interventional Radiology - December 4, 2018 Category: Radiology Authors: Doyoung Chang, Srini Tummala, Dax Sotero, Eric Tong, Luai Mustafa, Moawiah Mustafa, William F. Browne, Ronald S. Winokur Source Type: research

FM : Editorial board - pick up from last issue
(Source: Techniques in Vascular and Interventional Radiology)
Source: Techniques in Vascular and Interventional Radiology - December 1, 2018 Category: Radiology Source Type: research