Treatment of Primary Liver Tumors and Liver Metastases, Part 1: Nuclear Medicine Techniques

J Nucl Med. 2018 Nov;59(11):1649-1654. doi: 10.2967/jnumed.116.186346. Epub 2018 Aug 2.

Abstract

90Y radioembolization is an increasingly used treatment for both primary and metastatic malignancy in the liver. Understanding the biophysical properties, dosing concerns, and imaging appearance of this treatment is important for interventional radiologists and nuclear medicine physicians to provide important therapy. 90Y radioembolization is efficacious and safe, although the possibility of complications does exist. This article provides a comprehensive in-depth discussion about the indications for 90Y radioembolization, reviews the role of preprocedural angiography and 99mTc-macroaggregated albumin scans, illustrates different dosing techniques, compares and contrasts resin and glass microspheres, and describes potential complications.

Keywords: 90Y radioembolization; MAA; hepatocellular carcinoma; liver, cancer.

Publication types

  • Review

MeSH terms

  • Angiography / methods
  • Carcinoma, Hepatocellular / diagnostic imaging
  • Carcinoma, Hepatocellular / secondary*
  • Carcinoma, Hepatocellular / therapy*
  • Education, Medical, Continuing
  • Embolization, Therapeutic / adverse effects
  • Embolization, Therapeutic / methods
  • Humans
  • Liver Neoplasms / diagnostic imaging
  • Liver Neoplasms / secondary*
  • Liver Neoplasms / therapy*
  • Microspheres
  • Nuclear Medicine / education
  • Nuclear Medicine / methods*
  • Radiopharmaceuticals / therapeutic use
  • Radiotherapy Dosage
  • Single Photon Emission Computed Tomography Computed Tomography / methods
  • Technetium Tc 99m Aggregated Albumin
  • Whole Body Imaging / methods
  • Yttrium Radioisotopes / therapeutic use

Substances

  • Radiopharmaceuticals
  • Technetium Tc 99m Aggregated Albumin
  • Yttrium Radioisotopes
  • Yttrium-90