"The transcatheter hepatic artery infusion of radioisotope delivers high doses of intratumoural radiation, while sparing the surrounding healthy liver parenchyma (or at least only delivers a low, tolerable dose to normal liver)."
"Re-188 has found growing interest as a poor man's Y90 due to the long (6month) half life of its generator."
"injection of 99mTc-MAA (macroaggregated albumin) into the hepatic artery proper with follow up scintigraphy to determine the degree of shunting to lungs (lung shunt fraction) and bowel"
"preliminary angiogram to determine vascular anatomy, confirm location of metastases, inject 99mTc-MAA for scan shortly after angiogram, determine extrahepatic arteries arising from the coeliac axis that will need to be avoided or embolised including cystic artery if gallbladder is still present"
"pre-procedure evaluation"
"Post-procedure evaluation"
"injection of 99mTc-MAA (macroaggregated albumin) into the hepatic artery proper with follow up scintigraphy to determine the degree of shunting to lungs (lung shunt fraction) and bowel"
"preliminary angiogram to determine vascular anatomy, confirm location of metastases, inject 99mTc-MAA for scan shortly after angiogram, determine extrahepatic arteries arising from the coeliac axis that will need to be avoided or embolised including cystic artery if gallbladder is still present"
"Eastern Cooperative Oncology Group (ECOG) performance status >3"
Expected headings
"Pathology"
"Procedure steps"
"Post-procedure evaluation"
"Potential complications"
"It is generally considered efficacious in patients with hepatocellular cancer, neuroendocrine and colorectal liver metastases 1. It generally involves a single delivery of yttrium-90 (Y-90) microspheres into the hepatic artery. Preferential uptake is achieved into liver tumours, because of their predominant hepatic arterial blood supply. Average tumour doses of radiation in excess of 200 Gy are achieved."
"nausea, vomiting, fever, diarrhoea and abdominal pain"
"transient lab abnormalities including liver function, haemoglobin and platelet levels"