Radioembolización Hepática con microesferas de 90Y: aspectos metodológicos y dosimétricos
Palabras clave:
90Y, Radioembolización, dosis absorbida, microesferas, dosimetría tridimensionalResumen
La radioembolización (RE) o radioterapia interna selectiva consiste en la administración de microesferas marcadas con 90Y por la arteria hepática. En un tratamiento de RE se llevan a cabo varios procesos: la valoración de la vascularización hepática, una adecuada planificación del tratamiento (que incluye una simulación del mismo), el cálculo de la actividad a administrar, la propia administración del tratamiento, y finalmente la evaluación de la distribución del tratamiento. Para ello es necesaria la colaboración de un equipo multidisciplinar formado por oncólogos, hepatólogos, radiólogos intervencionistas, médicos nucleares, radiofarmacéuticos y radiofísicos.
En los últimos años se ha producido un aumento del número de publicaciones que incluyen los aspectos dosimétricos de los tratamientos de RE y su relación con los efectos terapéuticos obtenidos. Una evaluación dosimétrica adecuada es fundamental para el desarrollo de un plan de tratamiento individualizado y para la optimización de la eficacia de la RE con una toxicidad aceptable.
En este trabajo se realiza una revisión de los principales aspectos metodológicos implicados en las diferentes etapas de un tratamiento de RE. Asimismo, se describen y analizan los diferentes modelos dosimétricos actualmente disponibles, incluyendo la dosimetría tridimensional a nivel de vóxel.
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