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EANM procedure guideline for the treatment of liver cancer and liver metastases with intra-arterial radioactive compounds

surgery (i.e. resection or liver transplantation), but only 10-20% of patients are candidates for this. In other patients, a variety of palliative treatments can be given, such as chemoembolization, radiofrequency ablation or recentlyPrimary liver cancers (i.e. hepatocellular carcinoma or cholangioc... Full description

Journal Title: European journal of nuclear medicine and molecular imaging 2011, Vol.38 (7), p.1393-1406
Main Author: Giammarile, F
Other Authors: Bodei, L , Chiesa, C , Flux, G , Forrer, F , Kraeber-Bodere, F , Brans, B , Lambert, B , Konijnenberg, Mark , Borson-Chazot, F , Tennvall, J , Luster, M
Format: Electronic Article Electronic Article
Language: English
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Publisher: Berlin/Heidelberg: Springer-Verlag
ID: ISSN: 1619-7070
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title: EANM procedure guideline for the treatment of liver cancer and liver metastases with intra-arterial radioactive compounds
format: Article
creator:
  • Giammarile, F
  • Bodei, L
  • Chiesa, C
  • Flux, G
  • Forrer, F
  • Kraeber-Bodere, F
  • Brans, B
  • Lambert, B
  • Konijnenberg, Mark
  • Borson-Chazot, F
  • Tennvall, J
  • Luster, M
subjects:
  • Ablation (Surgery)
  • Antibodies
  • Arteries
  • Assisted
  • Cancer
  • Cardiology
  • Chemotherapy
  • Clinical Medicine
  • Colorectal cancer
  • Computer
  • Contraindications
  • Drug therapy
  • Europe
  • Follow
  • Follow-Up Studies
  • Glass spheres
  • Guidelines
  • Health aspects
  • I-131-Ethiodized oil
  • I-131-Lipiodol
  • Imaging
  • Klinisk medicin
  • Life Sciences
  • Lipiocis (R)
  • Liver cancer
  • Liver Neoplasms
  • Liver Neoplasms - blood supply
  • Liver Neoplasms - radiotherapy
  • Liver Neoplasms - secondary
  • Medical
  • Medical and Health Sciences
  • Medicin och hälsovetenskap
  • Medicine
  • Medicine & Public Health
  • Metastasis
  • Microspheres
  • Nuclear Medicine
  • Nuclear Medicine - methods
  • Oncology
  • Oncology, Experimental
  • Orthopedics
  • Practice guidelines (Medicine)
  • Radiation
  • Radiation therapy
  • Radioactive Tracers
  • Radiologi och bildbehandling
  • Radiology
  • Radiology, Nuclear Medicine and Medical Imaging
  • Radiomicrospheres
  • Radiopharmaceuticals
  • Radiopharmaceuticals - adverse effects
  • Radiopharmaceuticals - chemistry
  • Radiopharmaceuticals - therapeutic use
  • Radiotherapy
  • Radiotherapy - adverse effects
  • Radiotherapy - methods
  • Radiotherapy - standards
  • Radiotherapy Planning
  • Radiotherapy Planning, Computer-Assisted
  • Reference Values
  • Resin-based spheres
  • SDG 3 - Good Health and Well-being
  • SIR-Spheres (R)
  • Societies
  • Societies, Medical
  • TheraSphere (R)
  • Transplantation of organs, tissues, etc
  • Tyrosine
  • Up Studies
  • Viral antibodies
  • Y-90-Microspheres
ispartof: European journal of nuclear medicine and molecular imaging, 2011, Vol.38 (7), p.1393-1406
description: surgery (i.e. resection or liver transplantation), but only 10-20% of patients are candidates for this. In other patients, a variety of palliative treatments can be given, such as chemoembolization, radiofrequency ablation or recentlyPrimary liver cancers (i.e. hepatocellular carcinoma or cholangiocarcinoma) are worldwide some of the most frequent cancers, with rapidly fatal liver failure in a large majority of patients. Curative therapy consists of introduced tyrosine kinase inhibitors, e. g. sorafenib. Colorectal cancer is the second most lethal cancer in Europe and liver metastases are prevalent either at diagnosis or in follow-up. These patients are usually treated by a sequence of surgery, chemotherapy and antibody therapy [Okuda et al. (Cancer 56: 918-928, 1985); Schafer and Sorrell (Lancet 353: 1253-1257, 1999); Leong et al. (Arnold, London, 1999)]. Radioembolization is an innovative therapeutic approach defined as the injection of micron-sized embolic particles loaded with a radioisotope by use of percutaneous intra-arterial techniques. Advantages of the use of these intra-arterial radioactive compounds are the ability to deliver high doses of radiation to small target volumes, the relatively low toxicity profile, the possibility to treat the whole liver including microscopic disease and the feasibility of combination with other therapy modalities. Disadvantages are mainly due to radioprotection constraints mainly for (131)I-labelled agents, logistics and the possibility of inadvertent delivery or shunting [Novell et al. (Br J Surg 78: 901-906, 1991)]. The Therapy, Oncology and Dosimetry Committees have worked together in order to revise the European Association of Nuclear Medicine (EANM) guidelines on the use of the radiopharmaceutical (131)I-Lipiodol (Lipiocis (R), IBA, Brussels, Belgium) and include the newer medical devices with (90)Y-microspheres. (90)Y is either bound to resin (SIR-Spheres (R), Sirtex Medical, Lane Cove, Australia) or embedded in a glass matrix (TheraSphere (R), MDS Nordion, Kanata, ON, Canada). Since (90)Y-microspheres are not metabolized, they are not registered as unsealed sources. However, the microspheres are delivered in aqueous solution: radioactive contamination is a concern and microspheres should be handled, like other radiopharmaceuticals, as open sources. The purpose of this guideline is to assist the nuclear medicine physician in treating and managing patients undergoing such treatment. (131)I-Lipiodol is a conso
language: eng
source:
identifier: ISSN: 1619-7070
fulltext: no_fulltext
issn:
  • 1619-7070
  • 1619-7089
url: Link


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titleEANM procedure guideline for the treatment of liver cancer and liver metastases with intra-arterial radioactive compounds
creatorGiammarile, F ; Bodei, L ; Chiesa, C ; Flux, G ; Forrer, F ; Kraeber-Bodere, F ; Brans, B ; Lambert, B ; Konijnenberg, Mark ; Borson-Chazot, F ; Tennvall, J ; Luster, M
creatorcontribGiammarile, F ; Bodei, L ; Chiesa, C ; Flux, G ; Forrer, F ; Kraeber-Bodere, F ; Brans, B ; Lambert, B ; Konijnenberg, Mark ; Borson-Chazot, F ; Tennvall, J ; Luster, M ; Therapy, Oncology and Dosimetry Committees ; the Therapy, Oncology and Dosimetry Committees
descriptionsurgery (i.e. resection or liver transplantation), but only 10-20% of patients are candidates for this. In other patients, a variety of palliative treatments can be given, such as chemoembolization, radiofrequency ablation or recentlyPrimary liver cancers (i.e. hepatocellular carcinoma or cholangiocarcinoma) are worldwide some of the most frequent cancers, with rapidly fatal liver failure in a large majority of patients. Curative therapy consists of introduced tyrosine kinase inhibitors, e. g. sorafenib. Colorectal cancer is the second most lethal cancer in Europe and liver metastases are prevalent either at diagnosis or in follow-up. These patients are usually treated by a sequence of surgery, chemotherapy and antibody therapy [Okuda et al. (Cancer 56: 918-928, 1985); Schafer and Sorrell (Lancet 353: 1253-1257, 1999); Leong et al. (Arnold, London, 1999)]. Radioembolization is an innovative therapeutic approach defined as the injection of micron-sized embolic particles loaded with a radioisotope by use of percutaneous intra-arterial techniques. Advantages of the use of these intra-arterial radioactive compounds are the ability to deliver high doses of radiation to small target volumes, the relatively low toxicity profile, the possibility to treat the whole liver including microscopic disease and the feasibility of combination with other therapy modalities. Disadvantages are mainly due to radioprotection constraints mainly for (131)I-labelled agents, logistics and the possibility of inadvertent delivery or shunting [Novell et al. (Br J Surg 78: 901-906, 1991)]. The Therapy, Oncology and Dosimetry Committees have worked together in order to revise the European Association of Nuclear Medicine (EANM) guidelines on the use of the radiopharmaceutical (131)I-Lipiodol (Lipiocis (R), IBA, Brussels, Belgium) and include the newer medical devices with (90)Y-microspheres. (90)Y is either bound to resin (SIR-Spheres (R), Sirtex Medical, Lane Cove, Australia) or embedded in a glass matrix (TheraSphere (R), MDS Nordion, Kanata, ON, Canada). Since (90)Y-microspheres are not metabolized, they are not registered as unsealed sources. However, the microspheres are delivered in aqueous solution: radioactive contamination is a concern and microspheres should be handled, like other radiopharmaceuticals, as open sources. The purpose of this guideline is to assist the nuclear medicine physician in treating and managing patients undergoing such treatment. (131)I-Lipiodol is a consolidated treatment option and the previous European Association of Nuclear Medicine (EANM) guidelines have been revised for its use. The newer (90)Y-microsphere therapy is rapidly expanding throughout the nuclear medicine community. To date, published data on microspheres, particularly on dosimetry features and the characterization of the objective response, are still preliminary. Therefore, the aim of this part of the document is to set up a first basic procedure to guide nuclear medicine physicians in treatment with radiolabelled microspheres.
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0ISSN: 1619-7070
1EISSN: 1619-7089
2DOI: 10.1007/s00259-011-1812-2
3PMID: 21494856
languageeng
publisherBerlin/Heidelberg: Springer-Verlag
subjectAblation (Surgery) ; Antibodies ; Arteries ; Assisted ; Cancer ; Cardiology ; Chemotherapy ; Clinical Medicine ; Colorectal cancer ; Computer ; Contraindications ; Drug therapy ; Europe ; Follow ; Follow-Up Studies ; Glass spheres ; Guidelines ; Health aspects ; I-131-Ethiodized oil ; I-131-Lipiodol ; Imaging ; Klinisk medicin ; Life Sciences ; Lipiocis (R) ; Liver cancer ; Liver Neoplasms ; Liver Neoplasms - blood supply ; Liver Neoplasms - radiotherapy ; Liver Neoplasms - secondary ; Medical ; Medical and Health Sciences ; Medicin och hälsovetenskap ; Medicine ; Medicine & Public Health ; Metastasis ; Microspheres ; Nuclear Medicine ; Nuclear Medicine - methods ; Oncology ; Oncology, Experimental ; Orthopedics ; Practice guidelines (Medicine) ; Radiation ; Radiation therapy ; Radioactive Tracers ; Radiologi och bildbehandling ; Radiology ; Radiology, Nuclear Medicine and Medical Imaging ; Radiomicrospheres ; Radiopharmaceuticals ; Radiopharmaceuticals - adverse effects ; Radiopharmaceuticals - chemistry ; Radiopharmaceuticals - therapeutic use ; Radiotherapy ; Radiotherapy - adverse effects ; Radiotherapy - methods ; Radiotherapy - standards ; Radiotherapy Planning ; Radiotherapy Planning, Computer-Assisted ; Reference Values ; Resin-based spheres ; SDG 3 - Good Health and Well-being ; SIR-Spheres (R) ; Societies ; Societies, Medical ; TheraSphere (R) ; Transplantation of organs, tissues, etc ; Tyrosine ; Up Studies ; Viral antibodies ; Y-90-Microspheres
ispartofEuropean journal of nuclear medicine and molecular imaging, 2011, Vol.38 (7), p.1393-1406
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8Konijnenberg, Mark
9Borson-Chazot, F
10Tennvall, J
11Luster, M
12Therapy, Oncology and Dosimetry Committees
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0EANM procedure guideline for the treatment of liver cancer and liver metastases with intra-arterial radioactive compounds
1European journal of nuclear medicine and molecular imaging
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0Eur J Nucl Med Mol Imaging
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descriptionsurgery (i.e. resection or liver transplantation), but only 10-20% of patients are candidates for this. In other patients, a variety of palliative treatments can be given, such as chemoembolization, radiofrequency ablation or recentlyPrimary liver cancers (i.e. hepatocellular carcinoma or cholangiocarcinoma) are worldwide some of the most frequent cancers, with rapidly fatal liver failure in a large majority of patients. Curative therapy consists of introduced tyrosine kinase inhibitors, e. g. sorafenib. Colorectal cancer is the second most lethal cancer in Europe and liver metastases are prevalent either at diagnosis or in follow-up. These patients are usually treated by a sequence of surgery, chemotherapy and antibody therapy [Okuda et al. (Cancer 56: 918-928, 1985); Schafer and Sorrell (Lancet 353: 1253-1257, 1999); Leong et al. (Arnold, London, 1999)]. Radioembolization is an innovative therapeutic approach defined as the injection of micron-sized embolic particles loaded with a radioisotope by use of percutaneous intra-arterial techniques. Advantages of the use of these intra-arterial radioactive compounds are the ability to deliver high doses of radiation to small target volumes, the relatively low toxicity profile, the possibility to treat the whole liver including microscopic disease and the feasibility of combination with other therapy modalities. Disadvantages are mainly due to radioprotection constraints mainly for (131)I-labelled agents, logistics and the possibility of inadvertent delivery or shunting [Novell et al. (Br J Surg 78: 901-906, 1991)]. The Therapy, Oncology and Dosimetry Committees have worked together in order to revise the European Association of Nuclear Medicine (EANM) guidelines on the use of the radiopharmaceutical (131)I-Lipiodol (Lipiocis (R), IBA, Brussels, Belgium) and include the newer medical devices with (90)Y-microspheres. (90)Y is either bound to resin (SIR-Spheres (R), Sirtex Medical, Lane Cove, Australia) or embedded in a glass matrix (TheraSphere (R), MDS Nordion, Kanata, ON, Canada). Since (90)Y-microspheres are not metabolized, they are not registered as unsealed sources. However, the microspheres are delivered in aqueous solution: radioactive contamination is a concern and microspheres should be handled, like other radiopharmaceuticals, as open sources. The purpose of this guideline is to assist the nuclear medicine physician in treating and managing patients undergoing such treatment. (131)I-Lipiodol is a consolidated treatment option and the previous European Association of Nuclear Medicine (EANM) guidelines have been revised for its use. The newer (90)Y-microsphere therapy is rapidly expanding throughout the nuclear medicine community. To date, published data on microspheres, particularly on dosimetry features and the characterization of the objective response, are still preliminary. Therefore, the aim of this part of the document is to set up a first basic procedure to guide nuclear medicine physicians in treatment with radiolabelled microspheres.
subject
0Ablation (Surgery)
1Antibodies
2Arteries
3Assisted
4Cancer
5Cardiology
6Chemotherapy
7Clinical Medicine
8Colorectal cancer
9Computer
10Contraindications
11Drug therapy
12Europe
13Follow
14Follow-Up Studies
15Glass spheres
16Guidelines
17Health aspects
18I-131-Ethiodized oil
19I-131-Lipiodol
20Imaging
21Klinisk medicin
22Life Sciences
23Lipiocis (R)
24Liver cancer
25Liver Neoplasms
26Liver Neoplasms - blood supply
27Liver Neoplasms - radiotherapy
28Liver Neoplasms - secondary
29Medical
30Medical and Health Sciences
31Medicin och hälsovetenskap
32Medicine
33Medicine & Public Health
34Metastasis
35Microspheres
36Nuclear Medicine
37Nuclear Medicine - methods
38Oncology
39Oncology, Experimental
40Orthopedics
41Practice guidelines (Medicine)
42Radiation
43Radiation therapy
44Radioactive Tracers
45Radiologi och bildbehandling
46Radiology
47Radiology, Nuclear Medicine and Medical Imaging
48Radiomicrospheres
49Radiopharmaceuticals
50Radiopharmaceuticals - adverse effects
51Radiopharmaceuticals - chemistry
52Radiopharmaceuticals - therapeutic use
53Radiotherapy
54Radiotherapy - adverse effects
55Radiotherapy - methods
56Radiotherapy - standards
57Radiotherapy Planning
58Radiotherapy Planning, Computer-Assisted
59Reference Values
60Resin-based spheres
61SDG 3 - Good Health and Well-being
62SIR-Spheres (R)
63Societies
64Societies, Medical
65TheraSphere (R)
66Transplantation of organs, tissues, etc
67Tyrosine
68Up Studies
69Viral antibodies
70Y-90-Microspheres
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titleEANM procedure guideline for the treatment of liver cancer and liver metastases with intra-arterial radioactive compounds
authorGiammarile, F ; Bodei, L ; Chiesa, C ; Flux, G ; Forrer, F ; Kraeber-Bodere, F ; Brans, B ; Lambert, B ; Konijnenberg, Mark ; Borson-Chazot, F ; Tennvall, J ; Luster, M
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0Ablation (Surgery)
1Antibodies
2Arteries
3Assisted
4Cancer
5Cardiology
6Chemotherapy
7Clinical Medicine
8Colorectal cancer
9Computer
10Contraindications
11Drug therapy
12Europe
13Follow
14Follow-Up Studies
15Glass spheres
16Guidelines
17Health aspects
18I-131-Ethiodized oil
19I-131-Lipiodol
20Imaging
21Klinisk medicin
22Life Sciences
23Lipiocis (R)
24Liver cancer
25Liver Neoplasms
26Liver Neoplasms - blood supply
27Liver Neoplasms - radiotherapy
28Liver Neoplasms - secondary
29Medical
30Medical and Health Sciences
31Medicin och hälsovetenskap
32Medicine
33Medicine & Public Health
34Metastasis
35Microspheres
36Nuclear Medicine
37Nuclear Medicine - methods
38Oncology
39Oncology, Experimental
40Orthopedics
41Practice guidelines (Medicine)
42Radiation
43Radiation therapy
44Radioactive Tracers
45Radiologi och bildbehandling
46Radiology
47Radiology, Nuclear Medicine and Medical Imaging
48Radiomicrospheres
49Radiopharmaceuticals
50Radiopharmaceuticals - adverse effects
51Radiopharmaceuticals - chemistry
52Radiopharmaceuticals - therapeutic use
53Radiotherapy
54Radiotherapy - adverse effects
55Radiotherapy - methods
56Radiotherapy - standards
57Radiotherapy Planning
58Radiotherapy Planning, Computer-Assisted
59Reference Values
60Resin-based spheres
61SDG 3 - Good Health and Well-being
62SIR-Spheres (R)
63Societies
64Societies, Medical
65TheraSphere (R)
66Transplantation of organs, tissues, etc
67Tyrosine
68Up Studies
69Viral antibodies
70Y-90-Microspheres
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1Bodei, L
2Chiesa, C
3Flux, G
4Forrer, F
5Kraeber-Bodere, F
6Brans, B
7Lambert, B
8Konijnenberg, Mark
9Borson-Chazot, F
10Tennvall, J
11Luster, M
12Therapy, Oncology and Dosimetry Committees
13the Therapy, Oncology and Dosimetry Committees
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genrearticle
ristypeJOUR
atitleEANM procedure guideline for the treatment of liver cancer and liver metastases with intra-arterial radioactive compounds
jtitleEuropean journal of nuclear medicine and molecular imaging
stitleEur J Nucl Med Mol Imaging
addtitleEur J Nucl Med Mol Imaging
date2011
risdate2011
volume38
issue7
spage1393
epage1406
pages1393-1406
issn1619-7070
eissn1619-7089
abstractsurgery (i.e. resection or liver transplantation), but only 10-20% of patients are candidates for this. In other patients, a variety of palliative treatments can be given, such as chemoembolization, radiofrequency ablation or recentlyPrimary liver cancers (i.e. hepatocellular carcinoma or cholangiocarcinoma) are worldwide some of the most frequent cancers, with rapidly fatal liver failure in a large majority of patients. Curative therapy consists of introduced tyrosine kinase inhibitors, e. g. sorafenib. Colorectal cancer is the second most lethal cancer in Europe and liver metastases are prevalent either at diagnosis or in follow-up. These patients are usually treated by a sequence of surgery, chemotherapy and antibody therapy [Okuda et al. (Cancer 56: 918-928, 1985); Schafer and Sorrell (Lancet 353: 1253-1257, 1999); Leong et al. (Arnold, London, 1999)]. Radioembolization is an innovative therapeutic approach defined as the injection of micron-sized embolic particles loaded with a radioisotope by use of percutaneous intra-arterial techniques. Advantages of the use of these intra-arterial radioactive compounds are the ability to deliver high doses of radiation to small target volumes, the relatively low toxicity profile, the possibility to treat the whole liver including microscopic disease and the feasibility of combination with other therapy modalities. Disadvantages are mainly due to radioprotection constraints mainly for (131)I-labelled agents, logistics and the possibility of inadvertent delivery or shunting [Novell et al. (Br J Surg 78: 901-906, 1991)]. The Therapy, Oncology and Dosimetry Committees have worked together in order to revise the European Association of Nuclear Medicine (EANM) guidelines on the use of the radiopharmaceutical (131)I-Lipiodol (Lipiocis (R), IBA, Brussels, Belgium) and include the newer medical devices with (90)Y-microspheres. (90)Y is either bound to resin (SIR-Spheres (R), Sirtex Medical, Lane Cove, Australia) or embedded in a glass matrix (TheraSphere (R), MDS Nordion, Kanata, ON, Canada). Since (90)Y-microspheres are not metabolized, they are not registered as unsealed sources. However, the microspheres are delivered in aqueous solution: radioactive contamination is a concern and microspheres should be handled, like other radiopharmaceuticals, as open sources. The purpose of this guideline is to assist the nuclear medicine physician in treating and managing patients undergoing such treatment. (131)I-Lipiodol is a consolidated treatment option and the previous European Association of Nuclear Medicine (EANM) guidelines have been revised for its use. The newer (90)Y-microsphere therapy is rapidly expanding throughout the nuclear medicine community. To date, published data on microspheres, particularly on dosimetry features and the characterization of the objective response, are still preliminary. Therefore, the aim of this part of the document is to set up a first basic procedure to guide nuclear medicine physicians in treatment with radiolabelled microspheres.
copBerlin/Heidelberg
pubSpringer-Verlag
pmid21494856
doi10.1007/s00259-011-1812-2
oafree_for_read