Typical Treatment

A successful SIR-Spheres microspheres treatment requires the involvement of a multi-disciplinary team consisting of representatives from oncology (medical, radiation and/or surgical), nuclear medicine, interventional radiology and radiation safety.

Screening

• Patient referral - usually from oncology (medical, surgical or radiation)
• Consult - patient consults with the SIR-Spheres microspheres-authorized treatment team (radiation oncology, nuclear medicine and/or interventional radiology)
• Diagnostic imaging and angiograms - such as CT, MRA, PET or angiography to ensure there is acceptable hepatic vasculature for infusion of the microspheres and to identify size and location of tumors
• Lung perfusion study - with Technetium-99 MAA to ensure that there is not an unacceptable level of shunting from the liver to the lungs

Treatment

• Prior authorization - pre-certification with patient's insurance is obtained
• Patient notification - the patient is contacted to confirm candidacy for treatment, review procedure schedule, and provide patient/family education
• Treatment planning - the patient-specific dose is determined, and the written directive is drafted on or prior to the day of treatment
• Treatment scheduled - the dose is ordered by the hospital seven to ten days prior to the treatment date
• Patient-specific dose - the dose amount is drawn as per the written directive; usually performed in the "hot lab" of the Nuclear Medicine department
• Dose infused - typically in the Interventional Radiology Suite
• Post-procedure observation - recommended to include a SPECT scan
• Post-treatment follow-up - lab tests and PET or CT scan