The Experts below are selected from a list of 261 Experts worldwide ranked by ideXlab platform
Riad Salem - One of the best experts on this subject based on the ideXlab platform.
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transarterial radioembolization with Yttrium 90 for the treatment of hepatocellular carcinoma
Advances in Therapy, 2016Co-Authors: J Kallini, Riad Salem, A Gabr, Robert J LewandowskiAbstract:Background Hepatocellular carcinoma (HCC) is a common cause of worldwide mortality. Transarterial radioembolization (TARE) with Yttrium-90 (Y90), a transcatheter intra-arterial procedure performed by interventional radiology, has become widely utilized in managing HCC.
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Yttrium-90 Radioembolization for Hepatocellular Carcinoma
Seminars in nuclear medicine, 2016Co-Authors: Ryan Hickey, Robert J Lewandowski, Riad SalemAbstract:90 Y radioembolization refers to the selective, transcatheter, and intra-arterial injection of micrometer-sized particles loaded with the radioisotope Yttrium-90 for the treatment of primary and metastatic hepatic malignancies. In the treatment of intermediate- and advanced-stage hepatocellular carcinoma, 90 Y radioembolization provides favorable outcomes with minimal side effects, offering an alternative treatment option to other transarterial therapies, such as bland embolization and chemoembolization. This review provides an overview of the use of 90 Y radioembolization in the treatment of hepatocellular carcinoma, including patient selection criteria, dosimetry, and clinical outcomes.
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Side Effects of Yttrium-90 Radioembolization
Frontiers in oncology, 2014Co-Authors: Ahsun Riaz, Rafia Awais, Riad SalemAbstract:Limited therapeutic options are available for hepatic malignancies. Image guided targeted therapies have established their role in management of primary and secondary hepatic malignancies. Radioembolization with Yttrium-90 (90Y) microspheres is safe and efficacious for treatment of hepatic malignancies. The tumoricidal effect of radioembolization is predominantly due to radioactivity and not ischemia. This article will present a comprehensive review of the side effects that have been associated with radioembolization using 90Y microspheres. Some of the described side effects are associated with all transarterial procedures. Side effects specific to radioembolization will also be discussed in detail. Methods to decrease the incidence of these potential side effects will also be discussed.
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Yttrium-90 radioembolization in the management of liver malignancies.
Seminars in oncology, 2010Co-Authors: Ahsun Riaz, Robert J Lewandowski, Laura Kulik, Mary F. Mulcahy, Riad SalemAbstract:Primary and secondary liver tumors are common. Locoregional therapies are establishing a role in the management of liver tumors due to the limited roles of surgical and systemic therapies. Our review presents some general concepts associated with Yttrium-90 radioembolization and its specific utilization in various primary and secondary liver malignancies.
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Radiographic Response to Yttrium-90 Radioembolization in Anterior Versus Posterior Liver Segments
CardioVascular and Interventional Radiology, 2008Co-Authors: Saad M. Ibrahim, Robert J Lewandowski, Vanessa L. Gates, Laura Kulik, Mary F. Mulcahy, Robert K. Ryu, Kent T. Sato, Andrew C. Larson, Reed A. Omary, Riad SalemAbstract:The purpose of our study was to determine if preferential radiographic tumor response occurs in tumors located in posterior versus anterior liver segments following radioembolization with Yttrium-90 glass microspheres. One hundred thirty-seven patients with chemorefractory liver metastases of various primaries were treated with Yttrium-90 glass microspheres. Of these, a subset analysis was performed on 89 patients who underwent 101 whole-right-lobe infusions to liver segments V, VI, VII, and VIII. Pre- and posttreatment imaging included either triphasic contrast material-enhanced CT or gadolinium-enhanced MRI. Responses to treatment were compared in anterior versus posterior right lobe lesions using both RECIST and WHO criteria. Statistical comparative studies were conducted in 42 patients with both anterior and posterior segment lesions using the paired-sample t -test. Pearson correlation was used to determine the relationship between pretreatment tumor size and posttreatment tumor response. Median administered activity, delivered radiation dose, and treatment volume were 2.3 GBq, 118.2 Gy, and 1,072 cm^3, respectively. Differences between the pretreatment tumor size of anterior and posterior liver segments were not statistically significant ( p = 0.7981). Differences in tumor response between anterior and posterior liver segments were not statistically significant using WHO criteria ( p = 0.8557). A statistically significant correlation did not exist between pretreatment tumor size and posttreatment tumor response ( r = 0.0554, p = 0.4434). On imaging follow-up using WHO criteria, for anterior and posterior regions of the liver, (1) response rates were 50% (PR = 50%) and 45% (CR = 9%, PR = 36%), and (2) mean changes in tumor size were −41% and −40%. In conclusion, this study did not find evidence of preferential radiographic tumor response in posterior versus anterior liver segments treated with Yttrium-90 glass microspheres.
Yung Hsiang Kao - One of the best experts on this subject based on the ideXlab platform.
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Dose-response for Yttrium-90 resin microsphere radioembolisation.
Nuclear medicine communications, 2021Co-Authors: Yung Hsiang KaoAbstract:The fundamental premise of Yttrium-90 radioembolisation is to balance safety with efficacy. To achieve this, dose-response guidance must be provided. This is a tabulation of published data of key dose-response metrics for Yttrium-90 resin microsphere radioembolisation of liver malignancies. Metrics are expressed in terms of mean radiation absorbed doses (Gy), dose-volume histograms, Biologically Effective Doses, Normal Tissue Complication Probability and Tumour Control Probability.
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Yttrium-90 positron emission tomography for qualitative and quantitative assessment of residual activity in delivery apparatus after radioembolization.
Journal of nuclear medicine technology, 2020Co-Authors: Yung Hsiang Kao, Alicia Corlett, Katrina Jorna, Alexander Rhodes, Dinesh SivaratnamAbstract:Assessment of residual activity is critical for quality assurance after Yttrium-90 radioembolization. The resin microsphere manufacturer’s indirect method of estimating the residual activity is laborious and vulnerable to inaccuracies. Furthermore, their method cannot localize the exact site of residual activity. Yttrium-90 PET/CT for qualitative and quantitative assessment of residual activity has not been described. We show an example of Yttrium-90 PET/CT of residual activity in the delivery apparatus and catheters packed inside the delivery box. Focally intense residual activity was clearly localized to the stopcock junction. Residual activity was directly quantified by setting the PET volume-of-interest isocontour threshold to 1%.
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post radioembolization Yttrium 90 pet ct part 1 diagnostic reporting
EJNMMI research, 2013Co-Authors: Yung Hsiang Kao, Jeffrey D Steinberg, Youngsoon Tay, Gabriel Ky Lim, Jianhua Yan, David W Townsend, Angela Takano, M C BurgmansAbstract:Background Yttrium-90 (90Y) positron emission tomography with integrated computed tomography (PET/CT) represents a technological leap from 90Y bremsstrahlung single-photon emission computed tomography with integrated computed tomography (SPECT/CT) by coincidence imaging of low abundance internal pair production. Encouraged by favorable early experiences, we implemented post-radioembolization 90Y PET/CT as an adjunct to 90Y bremsstrahlung SPECT/CT in diagnostic reporting.
Srinivas Kappadath - One of the best experts on this subject based on the ideXlab platform.
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MO-A-217BCD-02: Yttrium-90 Microsphere Therapy Planning and Dose Calculations.
Medical Physics, 2012Co-Authors: Srinivas KappadathAbstract:Yttrium‐90 microsphere therapy, a form of radiation therapy, is an increasingly popular option for care of patients with liver metastases or unresectable hepatocellular carcinoma. The therapy directly delivers Yttrium‐90 microspheres via the hepatic artery to specifically targeted disease sites. Following Yttrium‐90 microsphere therapy, a vast majority of Yttrium‐90 microspheres preferentially lodge in neoplastic tissue due to their embolic size (mean diameter 32 μm) and targeted trans‐arterial delivery. Once embolized the microspheres do not migrate but deposits up to 90% of its energy in the first 5 mm of tissue. Prior to Yttrium‐90 microsphere therapy, a 99mTc‐MAA examination is conducted to evaluate catheter placement and lung‐shunt fraction. The lung shunt fraction and absorbed dose estimates for lung and liver that guide Yttrium‐90 administered activity are based on nuclear medicine imaging. A review of the pre‐ and post‐therapy imaging procedures underlying Yttrium‐90 microsphere therapy will be presented. Calculation of the lung shunt fraction and dosimetry models to estimate radiation absorbed doses will be discussed. Radiation safety issues will be also be reviewed. Learning Objectives: 1. To understand the imaging sequence for Yttrium‐90 microsphere therapy planning and dose calculations 2. To understand calculation of lung shunt fraction and estimation of absorbed dose for lung and liver 3. To become familiar with radiation safety and regulations surrounding Yttrium‐90 microsphere therapy
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TH‐A(SAM)‐211‐02: Yttrium‐90 Microsphere Therapy Planning and Dose Calculations
Medical Physics, 2011Co-Authors: Srinivas KappadathAbstract:Yttrium‐90 microsphere therapy, a form of radiation therapy, is an increasingly popular option for care of patients with liver metastases or unresectable hepatocellular carcinoma. The therapy directly delivers Yttrium‐90 microspheres via the hepatic artery to specifically targeted disease sites. Following Yttrium‐90 microsphere therapy, a vast majority of Yttrium‐90 microspheres preferentially lodge in neoplastic tissue due to their embolic size (mean diameter 32 μm) and targeted trans‐arterial delivery. Once embolized the microspheres do not migrate but deposits upto 90% of its energy in the first 5 mm of tissue. Prior to Yttrium‐90 microsphere therapy, a 99mTc‐MAA examination is conducted to evaluate catheter placement and lung‐shunt fraction. The lung shunt fraction and absorbed dose estimates for lung and liver that guide Yttrium‐90 administered activity are based on nuclear medicine imaging. A review of the pre‐ and post‐therapy imaging procedures underlying Yttrium‐ 90 microsphere therapy will be presented. Calculation of the lung shunt fraction and dosimetry models to estimate radiation absorbed doses will be discussed. Radiation safety issues will be also be reviewed. Educational Objectives: 1. To understand the imaging sequence for Yttrium‐90 microsphere therapy planning and dose calculations 2. To understand calculation of lung shunt fraction and estimation of absorbed dose for lung and liver 3. To become familiar with radiation safety and regulations surrounding Yttrium‐90 microsphere therapy
Leo I. Gordon - One of the best experts on this subject based on the ideXlab platform.
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Efficacy and safety of radioimmuno-therapy with Yttrium 90 ibritumomab tiuxetan (Zevalin)
Seminars in oncology nursing, 2004Co-Authors: Mary Beth Riley, Leo I. GordonAbstract:Abstract Objectives To detail recent developments pertaining to the efficacy and safety of radioimmunotherapy with Yttrium 90 ( 90 Y) ibritumomab tiuxetan for patients with B-cell non-Hodgkin’s lymphoma (NHL). Data sources Published clinical trials of 90 Y ibritumomab tiuxetan and secondary literature on radioimmunotherapy and NHL. Conclusion Yttrium 90 ibritumomab tiuxetan is safe and effective in the indicated population. It has a good safety profile and is generally well tolerated. It is not associated with the adverse events from conventional chemotherapy and external beam radiation therapy. Implications for nursing practice Nursing professionals who are aware of the efficacy and safety data associated with 90 Y ibritumomab tiuxetan can optimize efficacy and educate patients and their caregivers about the regimen.
Russell J Schilder - One of the best experts on this subject based on the ideXlab platform.
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Safety and efficacy of radioimmunotherapy with Yttrium 90 ibritumomab tiuxetan (Zevalin).
Seminars in nuclear medicine, 2004Co-Authors: Hossein Borghaei, Russell J SchilderAbstract:Patients with low-grade, follicular non-Hodgkin's lymphoma usually present with advanced disease, which is not considered curable with conventional therapies. New approaches are needed to improve the outcomes in patients with this disease. Yttrium 90 ibritumomab tiuxetan (Zevalin; Biogen Idec Inc, Cambridge, MA), is highly effective, with overall response rates of 73% to 83% and complete response rates of 15% to 51%, with a median duration of response in complete responders of 23 months. The response rates tend to be higher in patients who have been treated with fewer prior therapies, and (90)Y ibritumomab tiuxetan may be suitable for use early in the course of therapy. Delayed myelosuppression is the most common adverse effect, and it is predictable, reversible, and manageable. Yttrium 90 ibritumomab tiuxetan has less nonhematologic toxicity than chemotherapy, with only minimal alopecia, mucositis, nausea, or vomiting, and a lower incidence of infections. The ibritumomab tiuxetan regimen is routinely and safely given in an outpatient setting and is completed in 7 to 9 days, and is thus more convenient for patients than chemotherapy.
