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Radioembolization with 90Y Microspheres: Angiographic and Technical Considerations

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Abstract

The anatomy of the mesenteric system and the hepatic arterial bed has been demonstrated to have a high degree of variation. This is important when considering pre-surgical planning, catheterization, and trans-arterial hepatic therapies. Although anatomical variants have been well described, the characterization and understanding of regional hepatic perfusion in the context of radioembolization have not been studied with great depth. The purpose of this review is to provide a thorough discussion and detailed presentation of the angiographic and technical aspects of radioembolization. Normal vascular anatomy, commonly encountered variants, and factors involved in changes to regional perfusion in the presence of liver tumors are discussed. Furthermore, the principles described here apply to all liver-directed transarterial therapies.

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Authors and Affiliations

  1. Department of Radiology, Section of Interventional Radiology, Northwestern Memorial Hospital, Robert H. Lurie Comprehensive Cancer Center, Chicago, IL, USA

    Robert J. Lewandowski, Kent T. Sato, Bassel Atassi, Robert K. Ryu, Albert A. Nemcek Jr., Reed A. Omary & Riad Salem

  2. Department of Hepatology, Northwestern University, Chicago, IL, USA

    Laura Kulik

  3. Department of Radiology, Section of Interventional Radiology, The Johns Hopkins Hospital, Baltimore, MD, USA

    Jean-Francois Geschwind

  4. Department of Radiology, Section of Interventional Radiology, MD Anderson Cancer Center, University of Texas, Houston, TX, USA

    Ravi Murthy

  5. Department of Radiology, Section of Interventional Radiology, Medical College of Wisconsin, Milwaukee, WI, USA

    William Rilling

  6. Inland Imaging LLC, Angio/Interventional Section Providence/Sacred Heart Medical Center, Spokane, WA, USA

    David Liu

  7. Department of Interventional Radiology, University of New South Wales, Sydney, Australia

    Lourens Bester

  8. Departamento de Radiologia, Clinica Universitaria de Navarra, Pamplona, Navarra, Spain

    Jose Ignacio Bilbao

  9. Wake Radiology Oncology, Cary, NC, USA

    Andrew S. Kennedy

  10. Department of Radiology, 676 North St. Claire, Suite 800, Chicago, IL, 60611, USA

    Riad Salem

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  1. Robert J. Lewandowski
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  15. Riad Salem
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Corresponding author

Correspondence to Riad Salem.

Additional information

R.S. and J.-F.G. are consultants for MDS Nordion. R.M., D.L., L.B., and J.I.B. are proctors for Sirtex Medical. A.S.K. has received honoraria from MDS Nordion and Sirtex Medical. This work was not funded.

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Lewandowski, R.J., Sato, K.T., Atassi, B. et al. Radioembolization with 90Y Microspheres: Angiographic and Technical Considerations. Cardiovasc Intervent Radiol 30, 571–592 (2007). https://doi.org/10.1007/s00270-007-9064-z

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  • DOI: https://doi.org/10.1007/s00270-007-9064-z

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