Angiographic mapping procedure
hepatic arterial tumor, tumor, extrahepatic shunting
TUMOR
All procedures were performed by interventional radiologists with authorized user status and over 5 years of experience with radioembolization (NK, ZB). All patients underwent angiographic mapping with visceral angiography to assess hepatic arterial tumor supply and evaluated for any extrahepatic shunting [The patients were then brought back to interventional radiology for the second mapping procedure. Using the same techniques as above, a second mapping was performed using resin-based Y90 microspheres (Sirtex Medical, Woburn, MA, USA). Using the same catheters and microcatheters, and from the same microcatheter location from which MAA was administered, 555 MBq of 3-day precalibrated Y90 resin microspheres were administered as the scout dose (ScoutY90). If there was dual blood supply to the tumor, 10 mCi 37 MBq of Y90 was administered to each artery. This activity of 15 mCi was determined based on the author’s prior work demonstrating 481 MBq was sufficient for accurate imaging on both SPECT and position emission tomography (PET) [After the second mapping procedure, all catheters and sheaths were removed, and hemostasis was achieved with a trans-radial band or a femoral artery closure device. The patient was then transferred to nuclear medicine for Y90 PET/CT (Vision 600, Siemens, Hoffmann Estates, IL, USA). After discharge criteria were met, all patients were discharged home on the same day as their procedure.