BackTable Vascular & Interventional Ep. 555 Dosimetry University Part III: Optimizing Single-Session Treatments with Dr. Nima Kokabi and Dr. Tyler Sandow
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Jul 1, 2025 Join interventional oncologists Drs. Tyler Sandow and Nima Kokabi as they dive into the fascinating world of single-session Y90 treatments for liver tumors. They discuss the latest insights on patient selection and the workflow involved in this innovative approach, highlighting its cost-effectiveness and safety profile. The doctors share practical tips for optimizing treatment and tackling challenges in the procedure. They even delve into real cases, exploring strategies that can enhance patient outcomes, including the potential for combined therapies.
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Single Session Y90 Benefits
- Single session Y90 is safer and more cost-effective for small, localized liver tumors, offering rapid treatment with low lung dose risk.
- This approach reduces treatment time from 61 to 21 days and cuts costs by about 40%.
Tumor Location for Single Session
- For single session Y90, start with peripheral tumors (segments 2, 3, 6) as they typically have simpler vascular anatomy.
- Always use high-quality cone beam CT to accurately identify feeders and avoid unexpected vascular enhancement.
Dose Preparation for Efficiency
- Pre-draw multiple Y90 doses tailored to estimated perfused volumes (e.g., 150, 200, 250 cc) for efficiency during single session procedures.
- Adjust doses intra-procedurally based on real-time cone beam CT volume calculations to match anatomy and tumor feeding vessels.