Image-guided solutions for interventional oncology - Siemens ...

SIRT - a new apporach in minimally invasive tumor therapyRadioembolization (SIRT) is a relatively newpalliative treatment option for primary andsecondary liver tumors which combines theeffects of interstitial high-dose radiotherapyand arterial micro-embolization. The resinmicrospheres (SIR-Spheres®) are labelled withthe isotope yttrium 90. The microspheresserve as a radiation source and are infusedinto the hepatic arteries, resulting in theselected targeting of very high doses ofradiation to metastases via their arterialblood supply.Tobias Jakobs, M.D.,Department of RadiologyLudwig Maximilian University of Munich,Campus Grosshadern, Munich, GermanyDuring SIRT prophylactic embolization ofthe gastroduodenal artery is done routinely.Furthermore, to avoid ectopic implantationof yttrium 90 microspheres into aberrantvisceral vessels, a careful and meticulousangiography of the hepatic vasculature ismandatory. However, the differentiationbetween intrahepatic vessels and vesselsleading into the GI region is not easy in allcases, especially where extensive tumorburden is present or in patients whopreviously underwent surgical resection ofliver tumors. To avoid distribution or reflux ofmicrospheres outside the liver, identificationand occlusion of those vessels is crucial forpreventing side effects (e.g. gastric ulcers,pancreatitis skin ulcerations) in the patient.Courtesy of T. Jakobs, M. D.University of Munich, Germany10