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• W2947526675 abstract "From the perspective of medical physicists, nuclear medicine radiologists, and radiation oncologists involved in radioembolization, the ideal direction of the future of this therapy may appear dierent than it does to interventional radiologists. is is primarily due to the dierences in the common procedures in which each of these groups normally participate. Interventional radiologists focus on procedures that, while technically demanding, normally do not involve the physics, mathematics, or the related precision commonly employed in radiation oncology and nuclear medicine. Further, while the technical considerations involved in a complex vascular intervention necessitate careful review of pretreatment structural and angiographic imaging, most nuclear medicine procedures are completely imaging based, focusing on both function and structure to diagnose and treat the patient. e distinction between these two groups and the ownership that interventional radiologistsnormally have over patients undergoing radioembolization therapy have largely driven the radioembolization technical process in the past. Evidence for this can be seen in Chapters 4 and 5, where the manufacturer-recommended treatment-planning methods for radioembolization are largely based on simple empiric calculations that are only patient specic at the simplest level. For example, recall the specics of the body surface area (BSA) model oen employed for treatment planning using resin microspheres. In this model, the impact of height and weight on the prescribed dosage exceed the impact of relative tumor burden. Additionally, the tumor type, vascularity, prior treatment, homogeneity of uptake, and any other patient-specic factors are not considered. While BSA is widely used in medicine for determining dosages for medications such as chemotherapy, it certainly makes more sense for a systemic administration than for a local brachytherapy such as radioembolization. It is for these reasons that many medical physicists, nuclear medicine radiologists, and radiation oncologists new to radioembolization15.1 Introduction 30715.2 Background 30815.3 Toward improved treatment planning 30915.4 Improving efficacy and safety 31115.4.1 Enhancement of T:N 31115.4.2 Alternative methods to enhance tumor targeting 31415.5 Toward improved posttreatment imaging 31515.5.1 New tracers and methods 31515.5.2 Image analysis 31615.6 Toward extrahepatic tumor radioembolization 31815.7 Conclusions 318References 319nd themselves immediately frustrated with the seeming lack of precision associated with the current standard of care in radioembolization treatment planning. It should be noted that this brief discussion of the commonly employed BSA treatment planning method for resin microspheres is not unique in its lack of tumor specicity-the recommended method for glass microspheres is even less tumor specic and does not account for tumor burden at all. ose looking for a more detailed review of these methods should refer to Chapter 5." @default.
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• W2947526675 date "2016-10-18" @default.
• W2947526675 modified "2023-09-23" @default.
• W2947526675 title "The use of postprocedural imaging in the medical management of patients" @default.
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• W2947526675 doi "https://doi.org/10.1201/9781315369150-15" @default.
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