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PREPARATION:
Fasting for 4 hours for arteriography in both phases.
Anticoagulants should be withheld before the procedure – the nuclear medicine physician will give instructions during the interview.
Metformin should not be used on the day of the procedure, as well as in the following 48 hours.
HOW IS THE THERAPY PERFORMED?
Radioembolization is a procedure that consists of injecting small radioactive spheres into the artery that irrigates tumors located in the liver. Once injected, these small spheres impact each other at the end of the artery and emit radiation. This radiation manages to penetrate the tissues that are close to this artery and causes cell destruction. The range of this radiation is small, at a magnitude of millimeters.
1st stage:
An interview with the nuclear medicine physician should be scheduled to assess the eligibility of the procedure. In this interview, the patient must bring the results of all laboratory and imaging tests. Then, the nuclear medicine physician will discuss the case with the multidisciplinary team and schedule the procedure.
2nd stage:
Before performing therapy, a study of the hepatic arteries through arteriography, in addition to the search for a hepatopulmonary shunt, is necessary. These two exams are essential, because, based on the data from these exams, the amount of radiation that should be administered is calculated, in addition to studying the anatomy of the liver vessels. Hepatic arteriography is performed by an interventional radiologist in a radiology center/hospital. A puncture of the femoral artery (located in the inguinal region) will be made and a long catheter will be introduced into the hepatic artery. Once the catheter is located in the hepatic artery, iodinated contrast and the radiopharmaceutical will be injected. The patient will remain at rest for 1 to 2 hours until he or she is cleared by the radiologist for imaging at the nuclear medicine service. Image acquisition takes around 30 minutes.
3rd stage:
At another time, the therapy will be carried out in a hospital environment and under sedation. The duration of the procedure is around an hour and a half to two hours.
To administer the microbeads, the interventional radiologist will perform a puncture in the femoral artery that is located in the inguinal region. Once the artery is punctured, a long, flexible catheter will be introduced into the liver artery. Then, the microspheres will be administered through this catheter. The patient should remain at rest and under observation for 4 to 6 hours after embolization. They will then be sent to the nuclear medicine service for image acquisition, in order to confirm that the spheres were deposited in the liver.
Depending on the timing of the procedure and their recovery, the patient may be discharged on the same day or discharged on the next morning.
GUIDELINES AFTER THERAPY:
In the first 24 hours after the procedure, wash your hands thoroughly and flush the toilet two to three times after urinating. Do not urinate in the bath.
Keep a distance of 1 meter from the people in your life, sleep separately from your partner and avoid close contact with infants and pregnant women in the first three days after the procedure.
Do not become pregnant until two months after radioembolization.
IMPORTANT NOTES:
Some side effects such as fatigue, abdominal pain, nausea and fever may occur for a few hours. As a precaution, medications will be prescribed to prevent such symptoms.
Local discomfort, bleeding or bruising in the puncture region (inguinal region) may also occur. Compression measures will be carried out to minimize this effect. Although it is very rare, some microspheres may inadvertently be deposited in other organs, such as the stomach, intestines and gallbladder, leading to inflammation of these organs and, consequently, prolonging the hospital stay.
OE 0080 – Version: 00/2024
Made by: DIMEN Technical Team
PREPARATION:
Fasting for 4 hours for arteriography in both phases.
Anticoagulants should be withheld before the procedure – the nuclear medicine physician will give instructions during the interview.
Metformin should not be used on the day of the procedure, as well as in the following 48 hours.
HOW IS THE THERAPY PERFORMED?
Radioembolization is a procedure that consists of injecting small radioactive spheres into the artery that irrigates tumors located in the liver. Once injected, these small spheres impact each other at the end of the artery and emit radiation. This radiation manages to penetrate the tissues that are close to this artery and causes cell destruction. The range of this radiation is small, at a magnitude of millimeters.
1st stage:
An interview with the nuclear medicine physician should be scheduled to assess the eligibility of the procedure. In this interview, the patient must bring the results of all laboratory and imaging tests. Then, the nuclear medicine physician will discuss the case with the multidisciplinary team and schedule the procedure.
2nd stage:
Before performing therapy, a study of the hepatic arteries through arteriography, in addition to the search for a hepatopulmonary shunt, is necessary. These two exams are essential, because, based on the data from these exams, the amount of radiation that should be administered is calculated, in addition to studying the anatomy of the liver vessels. Hepatic arteriography is performed by an interventional radiologist in a radiology center/hospital. A puncture of the femoral artery (located in the inguinal region) will be made and a long catheter will be introduced into the hepatic artery. Once the catheter is located in the hepatic artery, iodinated contrast and the radiopharmaceutical will be injected. The patient will remain at rest for 1 to 2 hours until he or she is cleared by the radiologist for imaging at the nuclear medicine service. Image acquisition takes around 30 minutes.
3rd stage:
At another time, the therapy will be carried out in a hospital environment and under sedation. The duration of the procedure is around an hour and a half to two hours.
To administer the microbeads, the interventional radiologist will perform a puncture in the femoral artery that is located in the inguinal region. Once the artery is punctured, a long, flexible catheter will be introduced into the liver artery. Then, the microspheres will be administered through this catheter. The patient should remain at rest and under observation for 4 to 6 hours after embolization. They will then be sent to the nuclear medicine service for image acquisition, in order to confirm that the spheres were deposited in the liver.
Depending on the timing of the procedure and their recovery, the patient may be discharged on the same day or discharged on the next morning.
GUIDELINES AFTER THERAPY:
In the first 24 hours after the procedure, wash your hands thoroughly and flush the toilet two to three times after urinating. Do not urinate in the bath.
Keep a distance of 1 meter from the people in your life, sleep separately from your partner and avoid close contact with infants and pregnant women in the first three days after the procedure.
Do not become pregnant until two months after radioembolization.
IMPORTANT NOTES:
Some side effects such as fatigue, abdominal pain, nausea and fever may occur for a few hours. As a precaution, medications will be prescribed to prevent such symptoms.
Local discomfort, bleeding or bruising in the puncture region (inguinal region) may also occur. Compression measures will be carried out to minimize this effect. Although it is very rare, some microspheres may inadvertently be deposited in other organs, such as the stomach, intestines and gallbladder, leading to inflammation of these organs and, consequently, prolonging the hospital stay.
OE 0080 – Version: 00/2024
Made by: DIMEN Technical Team
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