For the first time, the injection of radioactive spheres for irradiation of liver tumors has been visualized live. An MRI scanner can be used to see exactly whether the radiation beads in the patient end up in the right place in the tumors.
Adjust live
The technique will make it possible in the future to adjust the injection location and dose per patient live. Researchers at Radboudumc in Nijmegen have discovered this and applied it to patients with liver cancer. The procedure is safe and feasible.
Are you reaching the right place?
Patients with tumors in the liver are sometimes injected with radioactive spheres into the hepatic artery. In the liver, these globules get stuck in the small blood vessels that supply the tumors with blood, where they irradiate the tumors from the inside. This therapy is called radioembolization. The spheres are injected into the blood vessel through a catheter, which a doctor places based on a scan made a week in advance. Only afterwards does a new scan show exactly where the spheres ended up. Not ideal, says Joey Roosen, PhD student at Radboudumc. “We sometimes see that we have not reached the tumors sufficiently, but there is nothing we can do about it at that time.”
Personalized
In the study of six patients, an attempt was made to solve this problem by following the spheres live during injection with an MRI scanner. Roosen: “In follow-up studies we can use this to move the catheter to another blood vessel, or adjust the dose, directly and individually tailored to the patient.”
Worldwide first
It is the first time worldwide that image-guided radioembolization has been performed in patients. During the MRI measurements, the researchers saw that 80 percent of all tumors measured were not yet full of globules. In those tumors you would therefore want to administer more spheres than usual, so that the treatment improves.
Follow-up study
The actual movement of the catheter and adjustment of the dose of spheres thanks to the MRI scanner is done in a follow-up study, which has also been started in the meantime. In time, the procedure could be suitable for any hospital in the world with an MRI scanner.
Also of interest: Lung cancer treatment in the future: ready while you wait