Transcatheter Intraarterial Therapies

Targeted CE per ARRT’s Discipline, Category, and Subcategory classification:
[Note: Discipline-specific Targeted CE credits may be less than the total Category A credits approved for this course.]

Registered Radiologist Assistant: 1.50
Procedures: 1.50
Abdominal Section: 1.50

Radiation Therapy: 1.50
Procedures: 1.50
Treatments: 1.50

Vascular-Interventional Radiography: 1.50
Procedures: 1.50
Vascular Interventional Procedures: 1.50

Outline

1. Introduction
2. Technical Considerations
3. Transarterial Embolization
   1. Background
   2. Clinical Evidence
4. Intraarterial Chemoinfusion
   1. Background
   2. Clinical Evidence
5. Transarterial Chemoembolization
   1. Background
   2. Clinical Evidence
6. Drug-eluting Microspheres
   1. Background
   2. Clinical Evidence
7. 90γ Radioembolization
   1. Background
   2. Clinical Evidence
8. Comparison of Transcatheter Therapies
9. Future Directions
   1. Background
   2. Combined Approaches
   3. Advances in Therapeutics
   4. Advances in Imaging
   5. Advances in Assessing Response to Therapy
10. Conclusion

Objectives

Upon completion of this course, students will:

1. understand the types of transcatheter transarterial therapies
2. be aware of how chemoembolization emerged as a standard of care
3. discuss how radioembolization has emerged over the past decade
4. know the source of hepatic blood supply
5. discuss why transcatheter intraarterial therapy works well for liver cancer
6. understand the importance of hepatic anatomy
7. know what procedure can be used to reduce adverse effects from transarterial chemoembolization
8. be familiar with embolizing agents used in transarterial embolization therapy
9. define a retrospective approach in clinical studies
10. be familiar with patient survival rates for transarterial embolization
11. understand which types of liver metastasis can be treated with transarterial embolization
12. know that bleeding can be treated with transcatheter arterial embolization
13. understand how regional drug therapy increases concentration of drugs
14. define in vivo
15. understand who performs the procedure to place arterial catheters
16. know the intended purpose of tumor embolization
17. describe patient populations that can benefit from transarterial chemoembolization
18. describe how drug-eluting beads are delivered to the tumor
19. understand TACE
20. know symptoms of postembolization therapy
21. discuss the first study regarding drug-eluting beads
22. know if drug-eluting bead therapy is safe and effective for all cancer patients
23. understand symptoms of clinical syndrome
24. discuss radioembolization
25. understand which transarterial therapies provide the least risk of hepatic necrosis
26. discuss clinical studies regarding time to cancer progression
27. discuss the Marelli et al study and which therapies the study compared
28. know what type of drug doxorubin is
29. know what type of lab animals are used to research transcatheter therapy
30. be familiar with the future of transcatheter therapy research
31. know the sizes and types of tumors that can be treated with intraarterial therapy
32. know how the metabolism of a tumor is affected by transcatheter therapy
33. know what makes digital subtraction angiography limited in transcatheter therapy
34. know what superselective radioembolism is
35. discuss the combined imaging technologies that assist with repositioning hepatic arterial catheters
36. know when follow up imaging is performed after cancer treatment
37. discuss functional imaging
38. understand agencies that provide radiologic tumor measurement guidelines
39. know what types of hepatic malignancies have been treated successfully with transcatheter intraarterial therapy
40. understand invasive level of transcatheter therapy