Caren van Roekel

67 Radioembolization may obliterate the need for coil-embolization of proximal branches, leading to a reduced procedure time, radiation dose and even costs (149, 150). Furthermore, by affecting the fluid-particle hemodynamics, the fixed catheter tip position may influence the distribution of the microspheres (151, 152). FIGURE 13. This image shows a prototype of the hybrid fluoroscopic and nuclear imaging device. With courtesy to Van der Velden et al. CONCLUSION Radioembolization is a minimal invasive therapy during which radioactive microspheres are injected into the hepatic artery. A microcatheter is placed in the hepatic arterial vasculature and millions of microspheres are administered, that selectively irradiate the tumors and relatively spare the healthy liver tissue. The essential steps for radioembolization are a visceral angiography to map the vascular anatomy, followed by a SPECT/CT after administration of a scout dose to assess lung shunt, exclude extrahepatic depositions and assess intrahepatic particle distribution, after which the optimal therapeutic activity is calculated and administered during a second visceral angiography. 2