BackTable Vascular & Interventional1 Jul 2025

Ep. 555 Dosimetry University Part III: Optimizing Single-Session Treatments with Dr. Nima Kokabi and Dr. Tyler Sandow

Will single session Y90 become the standard of care for HCC and oligo-metastatic disease? Tune in to our third installment of Dosimetry University with interventional oncologists Drs. Tyler Sandow, Nima Kokabi, and Kavi Krishnasamy as they share their experiences and best practices in single session Y90 treatment. --- This podcast is supported by: Sirtexhttps://www.sirtex.com/ Medtronic Emprinthttps://www.medtronic.com/emprint --- SYNPOSIS The doctors discuss the application and workflow of single session Y90 therapy for primary and oligo-metastatic liver tumors. They discuss the latest data from various institutions, emphasizing reduced lung dose, lower time to treatment, improved cost-efficiency, and the advantageous safety profile associated with single session treatment. The discussion also covers ideal patient selection based on tumor location and vascular characteristics, the importance of cone beam CT, and how to identify red-flag features of vascular enhancement. Our panel then reviews key technical considerations for single session success, including the use of flow-modifying microcatheters, gelfoam, and strategies for flow redirection. The episode concludes with a case discussion to explore the best strategy for a large liver tumor, detailing the specifics of each treatment and the potential role of combined therapies to achieve better long-term outcomes. --- TIMESTAMPS 00:00 - Introduction 00:47 - Single Session Y90: Workflow and Benefits03:52 - Patient Selection04:31 - Tumor Location and Preferred Techniques14:31 - Reperfusion and Redirection Techniques 26:16 - Case Study: Large Tumor Treatment37:01 - Long-Term Outcomes and Surgical Considerations

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