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BackTable Vascular & InterventionalThe BackTable Podcast is a resource for interventional radiologists, vascular surgeons, interventional cardiologists, and other interventional and endovascular specialists to learn tips, techniques, and the ins and outs of the devices in their cabinets. Author: BackTable
The BackTable Podcast is a resource for interventional radiologists, vascular surgeons, interventional cardiologists, and other interventional and endovascular specialists to learn tips, techniques, and the ins and outs of the devices in their cabinets. Listen on BackTable.com or on the streaming platform of your choice. You can also visit www.BackTable.com to browse our open access, physician-catered knowledge center for all things vascular and interventional; now featuring practice tools, procedure walkthroughs, and expert guidance on more than 40 endovascular procedures. Language: en Genres: Education, Health & Fitness, Medicine Contact email: Get it Feed URL: Get it iTunes ID: Get it Trailer: |
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Ep. 511 How to Simplify Dosing: Understanding Y-90 Dosimetry from Simple to Complex
Thursday, 23 January, 2025
Of all the topics covered during interventional radiology training, dosimetry education is often delayed until after IRs enter clinical practice. In this episode, Drs. Tyler Sandow and Sabeen Dhand host a roundtable discussion with experts on the dosimetry fundamentals that all Y90 operators should understand. They are joined by interventional radiologists Drs. Zachary Berman, Kirema Garcia-Reyes, and Siddharth Padia, who provide their expert insights. Physicians, nurses, nurse practitioners, and physician assistants can follow this link to earn CME / CE credits for completing an accredited learning activity related to this discussion: https://www.cmeuniversity.com/course/take/125736 --- This podcast is supported by an educational grant from: AstraZeneca https://www.astrazeneca.com/our-therapy-areas/oncology.html With additional support from: Boston Scientific https://www.bostonscientific.com/en-US/medical-specialties/interventional-radiology/interventional-oncology.html --- SYNPOSIS The group agrees that dosimetry is not a one-size-fits-all approach. Dosing strategies depend on factors such as tumor size, perfusion territory, underlying liver function, the choice between glass versus resin spheres, and treatment intent. These considerations are illustrated with real-life case examples. The doctors also explore voxel-based dosimetry, a method for calculating the amount of radiation absorbed by different parts of the tumor. They stress the importance of learning how to perform accurate dosage calculations. Finally, the conversation touches on data from major Y90 trials, current guidelines, and the evolving perspective on Y90 as a potential curative treatment, rather than merely a bridging therapy. --- TIMESTAMPS 00:00 - Introduction 01:59 - Dosimetry Education During Training 05:46 - Benefit of Individualized Dosing 11:01 - Complications from High Doses 15:19 - Dosage Calculation Cases 22:51 - Duration of Response to Y90 25:00 - Dosing Based on Treatment Intent 29:11 - Challenging Case Example 42:31 - Voxel-Based Dosimetry 45:15 - Using Dosimetry Software --- RESOURCES LEGACY Trial (Salem et al, 2021): https://pmc.ncbi.nlm.nih.gov/articles/PMC8596669/ Voxel-based tumor dose correlates to complete pathologic necrosis after transarterial radioembolization for hepatocellular carcinoma (Pianka et al, 2024): https://pubmed.ncbi.nlm.nih.gov/38913189/ RAPY90D Trial (Kappadath et al, 2023): https://jnm.snmjournals.org/content/64/supplement_1/P268 Clinical, dosimetric, and reporting considerations for Y-90 glass microspheres in hepatocellular carcinoma: updated 2022 recommendations from an international multidisciplinary working group (Salem et al, 2023): https://pubmed.ncbi.nlm.nih.gov/36114872/ International recommendations for personalised selective internal radiation therapy of primary and metastatic liver diseases with yttrium-90 resin microspheres (Levillain, 2021): https://link.springer.com/article/10.1007/s00259-020-05163-5)
