Abstract
Background
Intra-arterial brachytherapy with yttrium-90 (90Y) resin microspheres (radioembolization) is a procedure to selectively deliver high-dose radiation to tumors. The purpose of this research was to compare the radioembolic effect of 90Y-radioembolization versus the embolic effect of bland microspheres in the porcine kidney model.
Methods
In each of six pigs, ~25–33 % of the kidney volume was embolized with 90Y resin microspheres and an equivalent number of bland microspheres in the contralateral kidney. Kidney volume was estimated visually from contrast-enhanced fluoroscopy imaging. Morphologic and histologic analysis was performed 8–9 weeks after the procedure to assess the locations of the microspheres and extent of tissue necrosis from 90Y-radioembolization and bland embolization. A semi-quantified evaluation of the non-acute peri-particle and perivascular tissue reaction was conducted. All guidelines for the care and use of animals were followed.
Results
Kidneys embolized with 90Y-radioembolization decreased in mass by 30–70 % versus the contralateral kidney embolized with bland microspheres. These kidneys showed significant necrosis/fibrosis, avascularization, and glomerular atrophy in the immediate vicinity of the 90Y resin microspheres. By contrast, glomerular changes were not observed, even with clusters of bland microspheres in afferent arterioles. Evidence of a foreign body reaction was recorded in some kidneys with bland microspheres, and subcapsular scarring/infarction only with the highest load (4.96 × 106) of bland microspheres.
Conclusion
This study showed that radioembolization with 90Y resin microspheres produces localized necrosis/fibrosis and loss of kidney mass in a porcine kidney model. This result supports the study of 90Y resin microspheres for the localized treatment of kidney tumors.
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Acknowledgments
The authors wish to thank Markus Singleton (Nursing Unit Manager, Radiology Department, Westmead Private Hospital), Yasmin Lee (Radiographer, St George Private Hospital), and Melissa Muhs for their help during the study.
Funding
Research funding was provided by Sirtex Technology Pty Ltd, Unit F6 Parkview Building, Lane Cove Business Park, 16 Mars Road, Lane Cove, NSW, Australia, 2066.
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Dr. Suresh de Silva is a proctor for Sirtex Medical Ltd but does not receive payment for this service. Dr. David Cade is employed by Sirtex Medical Ltd, Sydney Australia as Medical Director. The remaining authors declare that they have no conflicts of interest.
Ethical Approval
All applicable institutional and/or national guidelines for the care and use of animals were followed. Ethics approval was granted by the University of New South Wales, Animal Care, and ‘Ethics Committee (ACEC) number 09/24B, dated 2nd March 2009.
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de Silva, S., Mackie, S., Aslan, P. et al. Histological Comparison of Kidney Tissue Following Radioembolization with Yttrium-90 Resin Microspheres and Embolization with Bland Microspheres. Cardiovasc Intervent Radiol 39, 1743–1749 (2016). https://doi.org/10.1007/s00270-016-1482-3
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DOI: https://doi.org/10.1007/s00270-016-1482-3