Yttrium-90 radioembolization of malignant tumors of the liver: Gallbladder effects

摘要

OBJECTIVE. After 90Y-microsphere radioembolization for unresectable hepatic neoplasms, the nearby gallbladder is susceptible to radiation-induced cholecystitis, an uncommon complication. The purpose of this study was to characterize the imaging findings after 90Y radioembolization of the gallbladder and to assess the incidence of clinically significant radiation-induced cholecystitis. MATERIALS AND METHODS. Medical records were retrospectively reviewed for cholecystectomy after 90Y treatment of 133 consecutively registered patients (76 men, 57 women; average age, 65 years). Thirty-four of the patients had primary and 99 had secondary liver neoplasms. The pretreatment and posttreatment cross-sectional images of 85 of the patients were available for review. RESULTS. Clinically significant radiation-induced cholecystitis occurred in 1 of the 133 patients (0.8%). After radioembolization, gallbladder imaging abnormalities were found in 84 of 85 patients (99%), but none was associated with clinically significant radiation-induced cholecystitis. CONCLUSION. The incidence of clinically significant radiation-induced cholecystitis was only 0.8% despite a high prevalence of gallbladder imaging abnormalities after 90Y radioembolization. Therefore, in the postinterventional care of patients with abdominal pain after 90Y radioembolization, even if imaging abnormalities of the gallbladder are identified, cholecystectomy should be reserved for patients in whom other causes of pain have been excluded.