REGULAR CONTENT
Final ID
497
Type
Original Scientific Research-Oral or Pos
Authors
S Young1, J Golzarian2, S Flanagan3, T Sanghvi4
Institutions
1University of Minnesota, Edina, MN, 2University of Minnesota, Minneapolis, MN, 3Northwestern Memorial Hospital, United States, 4University of Minnesota, Minnespolis, MN
Purpose
Yttrium-90 (Y90) therapy is commonly used to treat both primary and metastatic hepatic malignancies. Typically 1 month imaging follow up, similar to the practices following other liver directed therapies, is obtained. However, the difference in treatment mechanism causes 1 month imaging to be of questionable value following Y90. This study retrospectively reviews patients treated with Y90 therapy at a single institution to determine the frequency with which management is changed based upon 1 month imaging.
Materials & Methods
131 consecutive Y90 therapies in 100 patients between 1/1/2012 and 6/1/2016 were retrospectively reviewed, 15 patients who underwent 20 therapies were excluded due to insufficient data. 111 cases in 85 patients were included. 48 treatments in 35 patients were performed for non-hepatocellular carcinoma (HCC) malignancies while 63 treatments in 50 patients were performed for HCC. The patient charts were reviewed for basic laboratory data, procedural data, and follow up data. The 1 month follow up imaging was then reviewed retrospectively by a body radiologist to determine if any complications, new lesions, or new extrahepatic disease was revealed. The imaging was considered to change management if the findings caused a planned treatment to be canceled, a new treatment procedure to be performed, or a new chemotherapy regimen to be used.
Results
Of the 111 treatments the therapeutic plan was changed based upon 1 month imaging in 9 cases (8.1%). Treatment plans were changed in 7 of 48 (14.5%) non-HCC therapies and 2 of 63 (3.2%) therapies for HCC. Of the 111 treatments, 14 treatments (12.6%) had new lesions identified within the liver (12) or new extrahepatic lesions (5); 3 were found to have both new intra and extrahepatic disease. This corresponded to new lesions identified in 13 of 85 (15.3%) patients. When evaluated by indication, new intra or extrahepatic lesions were identified in 11 of 48 (22.9%) therapies for non-HCC and 3 of 63 (4.8%) therapies for HCC.
Conclusions
While management was infrequently changed, the rate of new lesion detection likely supports one month imaging in non-HCC Y90 patients but is of less clear benefit in patients with HCC.
Final ID
497
Type
Original Scientific Research-Oral or Pos
Authors
S Young1, J Golzarian2, S Flanagan3, T Sanghvi4
Institutions
1University of Minnesota, Edina, MN, 2University of Minnesota, Minneapolis, MN, 3Northwestern Memorial Hospital, United States, 4University of Minnesota, Minnespolis, MN
Purpose
Yttrium-90 (Y90) therapy is commonly used to treat both primary and metastatic hepatic malignancies. Typically 1 month imaging follow up, similar to the practices following other liver directed therapies, is obtained. However, the difference in treatment mechanism causes 1 month imaging to be of questionable value following Y90. This study retrospectively reviews patients treated with Y90 therapy at a single institution to determine the frequency with which management is changed based upon 1 month imaging.
Materials & Methods
131 consecutive Y90 therapies in 100 patients between 1/1/2012 and 6/1/2016 were retrospectively reviewed, 15 patients who underwent 20 therapies were excluded due to insufficient data. 111 cases in 85 patients were included. 48 treatments in 35 patients were performed for non-hepatocellular carcinoma (HCC) malignancies while 63 treatments in 50 patients were performed for HCC. The patient charts were reviewed for basic laboratory data, procedural data, and follow up data. The 1 month follow up imaging was then reviewed retrospectively by a body radiologist to determine if any complications, new lesions, or new extrahepatic disease was revealed. The imaging was considered to change management if the findings caused a planned treatment to be canceled, a new treatment procedure to be performed, or a new chemotherapy regimen to be used.
Results
Of the 111 treatments the therapeutic plan was changed based upon 1 month imaging in 9 cases (8.1%). Treatment plans were changed in 7 of 48 (14.5%) non-HCC therapies and 2 of 63 (3.2%) therapies for HCC. Of the 111 treatments, 14 treatments (12.6%) had new lesions identified within the liver (12) or new extrahepatic lesions (5); 3 were found to have both new intra and extrahepatic disease. This corresponded to new lesions identified in 13 of 85 (15.3%) patients. When evaluated by indication, new intra or extrahepatic lesions were identified in 11 of 48 (22.9%) therapies for non-HCC and 3 of 63 (4.8%) therapies for HCC.
Conclusions
While management was infrequently changed, the rate of new lesion detection likely supports one month imaging in non-HCC Y90 patients but is of less clear benefit in patients with HCC.