Interesting - small retrospectively analysed sample, but from...

Interesting - small retrospectively analysed sample, but from some major centres in London.
Possibly opens up usage after partial liver resection. No view on possible market, but cutting out tumors can be a little hit and miss. One would generally take a good margin, but for a number of reasons there is often some residual cancerous cells remaining.
Published in May 2013, but first time I've come across it. Apologies if of no interest!
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http://jnm.snmjournals.org/content/...id=1&usestrictdates=yes&resourcetype=HWCIT&ct

SIRT is safe in the remnant liver post partial liver resection

1. R. Chakravartty1,
2. S. Alshahwan1,
3. B. Corcoran1,
4. Wendy Martin3,
5. P. Kane2,
6. D. Lewis2,
7. P. Peddu2,
8. Ounali Jaffer2,
9. Nicola Mulholland1 and
10. Gillian Vivian1

+ Author Affiliations

1. 1Nuclear Medicine, Kings College Hospital NHS Trust, London, United Kingdom
2. 2Radiology, Kings College Hospital NHS Trust, London, United Kingdom
3. 3Liver, Renal and Surgery Division, Kings College Hospital NHS Trust, London, United Kingdom

Abstract

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Objectives Selective intrahepatic radionuclide therapy (SIRT) is a novel approach, generally used to treat surgically unresectable metastatic hepatic lesions. We assessed the safety and efficacy of SIRT in treating hepatic metastases in the remnant liver after liver resection, where the depleted liver volume raises concerns of inducing radiation hepatitis.
Methods This study retrospectively analysed patients undergoing SIRT between January 2009 and December 2012 after partial liver resection. SIRT was performed using 90Y resin microspheres to selectively target recurrent metastatic lesions, after remnant liver and tumour volume estimations on axial imaging and appropriate dose calculations. Patient demographics, tumour biology, hepatic vasculature details and complications were assessed. Response assessment on axial imaging was performed 8 weeks later to assess size and necrosis within the targeted lesions.
Results Overall 13 patients (8 men, 5 women, median age 62 years) with hepatic metastatic tumours and Child Pugh A scores underwent SIRT after liver resection( 6 right hepatectomies, 3 left hepatectomies and 4 segmental resections in both lobes). The median remnant liver volume was 1738ml (range: 1596 to 2370 ml), targeted tumour ranged between 1 and 20% of the remnant liver volume and a median treatment dose of 1.7 GBq (range: 0.9 to 2.2 GBq). No immediate complications were encountered and transient radiation hepatitis at 4 weeks occurred in 1 patient. All lesions with particle deposition on post therapy imaging showed central necrosis on response assessment imaging but were considered stable disease on size based criteria.
Conclusions SIRT is a safe and effective treatment for the reduction of hepatic metastatic burden in the remnant liver following liver resection.