Ep. 556 Dosimetry University IV: Optimizing Radiation Segmentectomy with Dr. Nima Kokabi and Dr. Tyler Sandow

Radiation segmentectomy: who, when, how? Interventional oncologists Dr. Nima Kokabi, Dr. Tyler Sandow, and Dr. Kavi Krishnasamy continue their in-studio discussion on all things Y90 in Part 4 of Dosimetry University, focusing on specific applications of radiation segmentectomy. --- This podcast is supported by: Sirtexhttps://www.sirtex.com/ Medtronic Emprinthttps://www.medtronic.com/emprint --- SYNPOSIS This session kicks off with a discussion on the curative potential of Y90, comparing it to other curative modalities like resection. The doctors discuss the importance of achieving a complete pathological necrosis (CPN) with Y90 for better survival outcomes, especially in the context of liver transplantation. The conversation also covers personalized approaches for treating liver-dominant metastatic cancers using Y90, and strategic considerations when choosing between techniques like radiation lobectomy, thermal ablation, and chemoembolization. The interventional oncologists explore the viability of radiation segmentectomy in treating small lesions and discuss data supporting its efficacy. Real-world clinical cases are examined to highlight the practical application of these therapies, their impact on overall survival, and the intricacies of dosimetry and patient selection. --- TIMESTAMPS 00:00 - Introduction01:07 - Ablative Y90 Curative Outcomes and Survival Rates02:16 - Radiation Segmentectomy vs. Ablation09:22 - Case Study: Metastatic Colorectal Cancer18:06 - Tumor Distinction on Cone Beam CT19:58 - Case Study: 77-Year-Old Female with Breast and Colorectal Cancer21:09 - Challenges and Techniques in Selective Radiation Segmentectomy24:28 - Avastin and Y9028:16 - Case Study: 53-Year-Old Male with Metastatic Colorectal Cancer29:40 - Radiation Lobectomy and Hypertrophy Strategies32:37 - Approaches for Metastatic and HCC Patients