Same day yttrium-90 radioembolization with single photon emission computed tomography/computed tomography: An opportunity to improve care during the COVID-19 pandemic and beyond

作     者：Mohammad Elsayed Mohammad Loya James Galt David M Schuster Zachary L Bercu Janice Newsome David Brandon Sonia Benenati Keywan Behbahani Richard Duszak Ila Sethi Nima Kokabi 

作者机构：Division of Interventional Radiology and Image-Guided MedicineDepartment of Radiology and Imaging SciencesEmory University School of MedicineAtlantaGA 30322United States Division of Nuclear Medicine and Molecular ImagingDepartment of Radiology and Imaging SciencesEmory University School of MedicineAtlantaGA 30322United States 

出 版 物：《World Journal of Gastrointestinal Oncology》 (世界胃肠肿瘤学杂志（英文版）（电子版）)

年 卷 期：2021年第13卷第5期

页      面：440-452页

核心收录：

学科分类：1011[医学-护理学（可授医学、理学学位）] 10[医学] 

基　　金：Sirtex Medical Ltd Harvey L. Neiman Health Policy Institute, HPI 

主　　题：Yttrium-90 radioembolization Same day Selective internal radiotherapy Transarterial radioembolization Single photon emission computed tomography/computed tomography Dosimetry COVID-19 

摘      要：BACKGROUND The coronavirus disease 2019(COVID-19)pandemic has made it more challenging for patients to undergo yttrium-90(Y-90)radioembolization(RE).Same day Y-90 RE provides an opportunity to minimize logistical challenges and infection risk associated with COVID-19,thus improving patient *** To describe the use of same day Y-90 RE with routine single photon emission computed tomography/computed tomography(SPECT/CT)in order to optimize *** All patients were selected for Y-90 RE through a multidisciplinary tumor board,and were screened and tested for COVID-19 infection per institutional protocol.A same day procedure was developed,consisting of angiography,imaging,and Y-90 resin particle *** SPECT/CT after technetium-99m macroaggregated albumin(Tc-99m MAA)administration was performed for assessment of arterial supply,personalized dosimetry,and extrahepatic ***-treatment Y-90 bremsstrahlung SPECT/CT was performed for confirmation of particle delivery,by utilization of energy windowing to limit signal from previously administered Tc-99m MAA *** A total of 14 patients underwent same day Y-90 RE between March and June *** lung shunt fraction was 6.13%(range 3.5%-13.1%).Y-90 RE was performed for a single lesion in 7 patients,while the remaining 7 patients had treatment of multifocal *** largest lesion measured 8.3 *** patients tolerated the procedure well and were discharged the same *** Same day Y-90 RE with resin-based microspheres is feasible,and provides an opportunity to mitigate infection risk and logistical challenges associated with the COVID-19 pandemic and *** recommend consideration of SPECT/CT,especially among patients with complex malignancies,for the potential to improve outcomes and eligibility of patients to undergo same day Y-90 RE.