Recommendations for radioembolisation after liver surgery using yttrium-90 resin microspheres based on a survey of an international expert panel

Morsal Samim, Linde M. van Veenendaal, Manon N.G.J.A. Braat, Andor F. van den Hoven, Richard Van Hillegersberg, Bruno Sangro, Yung Hsiang Kao, Dave Liu, John D. Louie, Daniel Y. Sze, Steven C. Rose, Daniel B. Brown, Hojjat Ahmadzadehfar, Edward Kim, Maurice A.A.J. van den Bosch, Marnix G.E.H. Lam

Research output: Contribution to journalArticlepeer-review

9 Scopus citations

Abstract

Introduction: Guidelines on how to adjust activity in patients with a history of liver surgery who are undergoing yttrium-90 radioembolisation (90Y-RE) are lacking. The aim was to study the variability in activity prescription in these patients, between centres with extensive experience using resin microspheres 90Y-RE, and to draw recommendations on activity prescription based on an expert consensus. Methods: The variability in activity prescription between centres was investigated by a survey of international experts in the field of 90Y-RE. Six representative post-surgical patients (i.e. comparable activity prescription, different outcome) were selected. Information on patients’ disease characteristics and data needed for activity calculation was presented to the expert panel. Reported was the used method for activity prescription and whether, how and why activity reduction was found indicated. Results: Ten experts took part in the survey. Recommendations on activity reduction were highly variable between the expert panel. The median intra-patient range was 44 Gy (range 18–55 Gy). Reductions in prescribed activity were recommended in 68% of the cases. In consensus, a maximum DTarget of 50 Gy was recommended. Conclusion: With a current lack of guidelines, large variability in activity prescription in post-surgical patients undergoing 90Y-RE exists. In consensus, DTarget ≤50 Gy is recommended. Key points: • BSA method does not account for a decreased remnant liver volume after surgery. • In post-surgical patients, a volume-based activity determination method is recommended. • In post-surgical patients, a mean DTargetof ≤ 50Gy should be aimed for.

Original languageEnglish
Pages (from-to)4923-4930
Number of pages8
JournalEuropean Radiology
Volume27
Issue number12
DOIs
StatePublished - 1 Dec 2017

Keywords

  • Dosimetry
  • Guidelines
  • Liver
  • Radioembolisation
  • Yttrium

Fingerprint

Dive into the research topics of 'Recommendations for radioembolisation after liver surgery using yttrium-90 resin microspheres based on a survey of an international expert panel'. Together they form a unique fingerprint.

Cite this