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Imaging characteristics following 90 yttrium microsphere treatment for unresectable liver cancer
Author(s) -
Bester Lourens,
Hobbins Peter G,
Wang Shihchang,
Salem Riad
Publication year - 2011
Publication title -
journal of medical imaging and radiation oncology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.31
H-Index - 43
eISSN - 1754-9485
pISSN - 1754-9477
DOI - 10.1111/j.1754-9485.2011.02241.x
Subject(s) - medicine , selective internal radiation therapy , radiology , microsphere , brachytherapy , positron emission tomography , radiation therapy , cancer , cancer imaging , nuclear medicine , hepatocellular carcinoma , chemical engineering , engineering
SUMMARY Selective internal radiation therapy (SIRT) with 90 yttrium microspheres – also known as radioembolisation – is a relatively new interventional radiology technique offering symptomatic and survival advantages for patients with unresectable liver cancer. However, in delivering both beta‐particle brachytherapy and embolisation of tumour vasculature, SIRT produces biological sequelae and imaging characteristics distinct from other treatment modalities. Current CT interpretation criteria consistently under‐report pathological responses to radioembolisation, diminishing both the prognosis and subsequent treatment choices for responding patients. However, newer criteria incorporating both tumour dimensions and enhancement characteristics improve the correlation with histopathology and provide substantially earlier confirmation of response. CT following radioembolisation may also identify parenchymal features that are often benign but may be mistaken for tumour progression. This review outlines imaging criteria specific to SIRT, including assessment of tumour response and interpretation of both lesion and parenchymal characteristics. The adjunctive role of additional modalities such as positron emission tomography is also addressed.