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Selective Internal Radiation Therapy (SIRT)

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A&I Protocol

[Left] Right hepatic artery angiogram; and [Right] Left hepatic artery angiogram showing bi-lobar tumours. Angiograms to show extent of blood supply to tumours and determine catheter position for Tc99-MAA (SIRT Work-up).

Cone-beam computed tomography (CBCT) of the right liver lobe with contrast highlighting the tumours in each segment.

Double catheter (and microcatheter) technique into the left and right hepatic artery. For SIRT Work-Up, these catheter positions are used to inject the Tc99-MAA. These catheter positions are replicated during the SIRT Implant procedure when injecting Y90 microspheres.

References

  1. Preston E, Shaida N. Selective internal radiation therapy in the management of primary and metastatic disease in the liver. Br J Hosp Med (Lond). 2021 Feb 2;82(2):1–11.

  2. Iñarrairaegui M, Sangro B. Selective Internal Radiation Therapy Approval for Early HCC: What Comes Next? Hepatology. 2021 Nov;74(5):2333–5.

  3. Welsh JS, Kennedy AS, Thomadsen B. Selective Internal Radiation Therapy (SIRT) for liver metastases secondary to colorectal adenocarcinoma. Int J Radiat Oncol Biol Phys. 2006;66(2 Suppl):S62-73.

  4. Prompers L, Bucerius J, Brans B, Temur Y, Berger L, Mottaghy FM. Selective internal radiation therapy (SIRT) in primary or secondary liver cancer. Methods. 2011 Nov;55(3):253–7.

  5. Sundram FX, Buscombe JR. Selective internal radiation therapy for liver tumours. Clin Med (Lond). 2017 Oct;17(5):449–53.

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