4 January 2019

For the first time Radboud university medical center has treated a patient with liver metastases by using holmium radio-embolization. With this technique, radioactive holmium microspheres are injected via a catheter into the liver artery. These microspheres then become stuck in the small blood vessels of tumors. As a result the tumor is irradiated from close proximity.

Patients with metastases in the liver or liver cancer can benefit from this form of internal irradiation, known as radio-embolization of the liver. With this technique, radioactive microspheres are injected with a catheter into the liver artery, after which they become stuck in the capillaries of the tumors. The microspheres then emit radiation with the goal of damaging the tumor as much as possible with minimal damage to normal tissue. This palliative (non-curative) form of therapy has been used for several years at Radboud university medical center, but with yttrium microspheres. For the first time, a patient has now been treated with holmium microspheres at Radboud university medical center. The most important difference between holmium and yttrium is the visibility of holmium on MRI, which yttrium lacks. This provides physicians with more information on the distribution of the microspheres in the liver, even during the procedure.
 
To the clinic
Radboud university medical center is the third medical center in the Netherlands that can offer this treatment with holmium spheres. Frank Nijsen, medical biologist at the department of Radiology and Nuclear Medicine at Radboud university medical center, is pleased with this innovation. More than a year ago he left UMC Utrecht – where he developed the therapy and founded the spin-off Quirem Medical to bring the therapy to the clinic – and joined Radboud university medical center. He wants to use the opportunities at Radboud university medical center to further improve the therapy.
 
MRI images
Nijsen: “Radboud university medical center has the MITeC, the Medical Innovation and Technology expert Center. This is a collection of innovative surgical facilities; for example, MRI is available in the OR itself. This is important because now we can make MRI images during surgery. This enables us to immediately confirm where the spheres are located and in what concentrations, and to adjust the therapy during the procedure if necessary. For the standard procedure, we do not yet use MRI, but we have submitted a research proposal to optimize radio-embolization with MRI.”
 
Preparation
Nuclear medicine physician Marcel Janssen, who performed the first procedure with interventional radiologist Mark Arntz and colleagues: “Several weeks before the actual treatment of the patient we already insert a catheter. Afterwards, we determine at what location in the liver artery we can best inject the spheres, we close any ‘leaks’ and we simulate the therapy by injecting soluble protein spheres and observing how they spread. Based on these insights, we decide whether the patient qualifies for the treatment. If all looks well, the patient will be treated 1 or 2 weeks afterwards.”
 
Improving results
Because real-time MRI imaging is not yet available, adjusting and fine tuning the therapy in individual patients is not yet possible. “We have demonstrated the efficacy of the therapy in previous studies,” says Nijsen. “By using MRI imaging while administering the microspheres, we hypothesize that we can direct the holmium spheres towards the tumor more effectively. We expect this will yield better outcomes, perhaps even with lower dosages. Over the next few years at the MITeC, we will investigate whether this is possible.”
___________________
Quirem Medical, a spin-off of UMC Utrecht, supplies the radioactive micospheres, which are prepared for use by Radboud Translational Medicine. For each treatment, approximately 30 million spheres are used with a diameter of approximately 30 micron. A micron is 0.001 millimeter.

Related news items


Radium 223-mediated zonal cytotoxicity of prostate cancer in bone

21 January 2019

In preclinical prostate carcinoma in the bone, Rad-223 eradicated effectively micro-tumors but macro-tumors persisted and expanded. The data point to application of Rad-223 in secondary prevention of early bone-metastatic disease and regimens co-targeting the tumor core.

read more

COPAL reveals remodeling of mitochondrial protein complexes in Barth syndrome

21 January 2019

Martijn Huijnen, theme Mitochondrial diseases, and colleagues developed COmplexome Profiling ALignment (COPAL) to systematically asses the effect of Barth syndome on mitochondrial protein complexes. They published their findings in Bioinformatics.

read more

Adjunct Professorship awarded to Barbara Franke at the Goethe University in Frankfurt am Main

21 January 2019

Barbara Franke is awarded an honorary Adjunct Professorship at the Goethe University in Frankfurt am Main in Germany.

read more

Ignacio Malagon, first professor of Pediatric Anaesthesiology in the Netherlands

21 January 2019

Ignacio Malagon has been appointed professor of Pediatric Anaesthesiology at Radboud University / Radboud university medical center with effect from 1 January 2019. He is the first professor in this field in the Netherlands.

read more

Two papers on molecular mechanisms of GFI1B in inherited bleeding syndromes in Haematologica

21 January 2019

Rinske van Oorschot from the Van der Reijden group, theme Cancer development and immune defense, has published two papers on the transcription factor GFI1B in Haematologica.

read more

Blog: Species Differences The Elephant in the Room

17 January 2019

Read the blog of Merel Ritskes-Hoitinga in the New England anti-vivisection society (neavs) based on a paper published in the Journal of Translational Medicine.

read more
  • Go to