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Outpatient Yttrium-90 microsphere radioembolization: assessment of radiation safety and quantification of post-treatment adverse events causing hospitalization

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Abstract

Purpose

Quantification of post-interventional adverse events of outpatient SIRT leading to hospitalization and quantification of radiation exposure.

Materials and methods

In this single-center, retrospective cohort study, we reviewed 212 patients treated with SIRT (90Y-microspheres) for primary and secondary liver malignancies. We searched for adverse events (AEs) and serious adverse events (SAEs), defined as AE’s causing hospitalization. Additionally, radiation exposure was measured in 36 patients.

Results

Seven patients had an SAE (3.3%), four patients had AE without readmission/hospitalization (1.9%) and 201 patients had no complications (94.8%). The mean ambient dose rate at 1 m distance from the source after administration of 90Y-microspheres was 1.88 µSv/h ± 0.74 (± SD) with a range from 4.3 to 0.2 µSv/h.

Conclusion

Outpatient radioembolization with 90Y-microspheres is safe and requires hospitalization only in a very small number of patients. The mean dose rate was low and met the national conditions for outpatient treatment (< 5 µSv/h).

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Abbreviations

99mTc-MAA:

Technetium-99m-labeled macroaggregated albumin

AE:

Adverse event

BCLC:

Barcelona clinic liver cancer

BSA:

Body surface area

SIRT:

Selective internal radiation therapy

CCC:

Cholangiocarcinoma

CI:

Confidence interval

CUP:

Cancer of unknown primary

DSA:

Digital subtraction arteriograms

eGFR:

Estimated glomerular filtration rate

HCC:

Hepatocellular carcinoma

NET:

Neuroendocrine tumor

RCC:

Renal cell carcinoma

SD:

Standard deviation

SPECT:

Single-photon emission computed tomography

TACE:

Transarterial chemoembolization

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Author information

Author notes

  1. Susanne Aberle and David Kenkel contributed equally to this work.

Authors and Affiliations

  1. Department of Oncology, University Hospital Zurich, Zurich, Switzerland

    Susanne Aberle

  2. Department of Nuclear Medicine, University Hospital Zurich, Zurich, Switzerland

    Irene Burger

  3. Department of Diagnostic and Interventional Radiology, University Hospital Zurich, Ramistrasse 100, 8091, Zurich, Switzerland

    David Kenkel, Anton S. Becker, Gilbert Puippe & Thomas Pfammatter

  4. Department of Nuclear Medicine, University Hospital Lausanne, Lausanne, Switzerland

    Niklaus Schaefer

Authors
  1. Susanne Aberle
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  2. David Kenkel
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  3. Anton S. Becker
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  4. Gilbert Puippe
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Correspondence to David Kenkel.

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Aberle, S., Kenkel, D., Becker, A.S. et al. Outpatient Yttrium-90 microsphere radioembolization: assessment of radiation safety and quantification of post-treatment adverse events causing hospitalization. Radiol med 125, 971–980 (2020). https://doi.org/10.1007/s11547-020-01180-4

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