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ACR–ABS–ACNM–ARS–SIR–SNMMI PRACTICE PARAMETER FOR RADIOEMBOLIZATION OF LIVER MALIGNANCIES

PREAMBLE

I.

INTRODUCTION

II.

INDICATIONS AND CONTRAINDICATIONS

III.

QUALIFICATIONS AND RESPONSIBILITIES OF PERSONNEL

III.

QUALIFICATIONS AND RESPONSIBILITIES OF PERSONNEL

A.

Interventional Radiologist

III.

QUALIFICATIONS AND RESPONSIBILITIES OF PERSONNEL

B.

Radiation Oncologists

III.

QUALIFICATIONS AND RESPONSIBILITIES OF PERSONNEL

C.

Nuclear Medicine Physician

III.

QUALIFICATIONS AND RESPONSIBILITIES OF PERSONNEL

D.

Qualified Medical Physicist

III.

QUALIFICATIONS AND RESPONSIBILITIES OF PERSONNEL

E.

Radiologic Technologists

III.

QUALIFICATIONS AND RESPONSIBILITIES OF PERSONNEL

F.

Nursing Services

IV.

SPECIFICATIONS OF THE PROCEDURE

A.

Preliminary Angiographic Evaluation

IV.

SPECIFICATIONS OF THE PROCEDURE

B.

Establishing Treatment Goals with Patient and Treatment Team

IV.

SPECIFICATIONS OF THE PROCEDURE

C.

Obtaining Informed Consent

IV.

SPECIFICATIONS OF THE PROCEDURE

D.

Pretreatment Evaluation

IV.

SPECIFICATIONS OF THE PROCEDURE

E.

Preliminary Angiographic Evaluation

IV.

SPECIFICATIONS OF THE PROCEDURE

F.

Variant Mesenteric Anatomy

IV.

SPECIFICATIONS OF THE PROCEDURE

G.

Radioembolization Treatment Plan

IV.

SPECIFICATIONS OF THE PROCEDURE

H.

Radioembolization Treatment Delivery

IV.

SPECIFICATIONS OF THE PROCEDURE

I.

Post-procedure Care

IV.

SPECIFICATIONS OF THE PROCEDURE

J.

Yttrium-90 Product Management

IV.

SPECIFICATIONS OF THE PROCEDURE

K.

Post-Treatment Verification

V.

PATIENT AND PERSONNEL SAFETY

VI.

DOCUMENTATION

VII.

RADIATION SAFETY

VIII.

EQUIPMENT SPECIFICATIONS

IX.

QUALITY CONTROL AND IMPROVEMENT, SAFETY, INFECTION CONTROL, AND PATIENT EDUCATION

ACKNOWLEDGEMENTS

Writing Committee – members represent their societies in the initial and final revision of this practice parameter

ACR Johnson, Thor MD, Chair Mercier, Gustavo MD, PhD Spieler, Benjamin MD	ARS Chundury, Anupama MD Folkert, Michael MD, PhD Russo, Suzanne MD Sio, Terence Tai-Weng MD, MS	SIR Farsad, Khashayar MD Kim, Charles Y MD Toskich, Beau MD Wang, David MD	SNMMI Kappadath, S. Cheenu PhD Muzahir, Saima MD Parent, Ephraim E MD
ABS Sharma, Navesh DO	ACNM Wright, Chadwick L MD, PhD

Committee on Practice Parameters – Nuclear Medicine and Molecular Imaging

(ACR Committee responsible for sponsoring the draft through the process)

Ghesani, Munir V MD, Chair	Subramaniam, Rathan M MBA, MD, MPH, PhD, Chair	Aboian, Mariam MD, PhD	Akin, Esma A MD
Bartel, Twyla B DO, MBA	Dibble, Elizabeth H MD	Gerard, Perry S MD	Karagulle Kendi, A. Tuba MD
Marcus, Charles MD	Mercier, Gustavo A MD, PhD	Peacock, Justin G MD, PhD	Solnes, Lilja B MBA, MD
Surasi, Devaki Shilpa MD	Trout, Andrew T MD	Wong, Terence Z MD, PhD	Zukotynski, Katherine MD, PhD

Committee on Practice Parameters – Radiation Oncology

(ACR Committee responsible for sponsoring the draft through the process)

Schechter, Naomi MD, Chair	Berkowitz, Aviva MD	Chao, Samuel MD	Davis, Brian J MD, PhD
Frank, Steven J MD	Freedman, Laura MD	Garsa, Adam MD	Lo, Simon S. ChB, MB
Morris, Zachary MD	Rabatic, Bryan MD	Reilly, Michael PhD	Saeed, Hina MD
Sio, Terence Tai-Weng MD, MS	Wallner, Paul DO

Committee on Practice Parameters – Interventional and Cardiovascular Radiology

(ACR Committee responsible for sponsoring the draft through the process)

Caplin, Drew M MD, Chair	Daly, Kevin MD	Dickey, Kevin MD	Gurusamy, Varshana MD
Kaufman, Claire MD	Kay, Dennis MD	Lee, Margaret H MD	Marx, M Victoria MD
Monfore, Natosha N DO	Noor, Amir MD	Tomihama, Roger T MD	Yeisley, Christopher MD

Committee on Practice Parameters and Technical Standards

(ACR Committee responsible for sponsoring the draft through the process)

Newell, Mary S MD, Chair

Caplin, Drew M MD

Committee on Practice Parameters – Nuclear Medicine and Molecular Imaging

(ACR Committee responsible for sponsoring the draft through the process)

Ghesani, Munir V MD, Chair	Subramaniam, Rathan M MBA, MD, MPH, PhD, Chair	Aboian, Mariam MD, PhD	Akin, Esma A MD
Bartel, Twyla B DO, MBA	Dibble, Elizabeth H MD	Gerard, Perry S MD	Karagulle Kendi, A. Tuba MD
Marcus, Charles MD	Mercier, Gustavo A MD, PhD	Peacock, Justin G MD, PhD	Solnes, Lilja B MBA, MD
Surasi, Devaki Shilpa MD	Trout, Andrew T MD	Wong, Terence Z MD, PhD	Zukotynski, Katherine MD, PhD

Committee on Practice Parameters – Radiation Oncology

(ACR Committee responsible for sponsoring the draft through the process)

Schechter, Naomi MD, Chair	Berkowitz, Aviva MD	Chao, Samuel MD	Davis, Brian J MD, PhD
Frank, Steven J MD	Freedman, Laura MD	Garsa, Adam MD	Lo, Simon S. ChB, MB
Morris, Zachary MD	Rabatic, Bryan MD	Reilly, Michael PhD	Saeed, Hina MD
Sio, Terence Tai-Weng MD, MS	Wallner, Paul DO

Larson, David B MBA, MD, Chair, Commission on Quality and Safety

Min, Robert MD, Chair, Commission on Interventional Radiology & Cardiovascular Imaging

Rohren, Eric MD, PhD, Chair, Commission on Nuclear Medicine & Molecular Imaging

Small, William MD, Chair, Commission on Radiation Oncology

Comments Reconciliation Committee

Rathi, Alisha MD - CSC, Co-Chair	Shah, Gaurang MD - CSC, Chair	Bartel, Twyla B DO, MBA	Caplin, Drew M MD
Chao, Samuel MD	Chundury, Anupama MD	Crummy, Timothy MD, MHA - CSC	Farsad, Khashayar MD
Folkert, Michael MD, PhD	Ghesani, Munir V MD	Johnson, Thor MD	Kappadath, S. Cheenu PhD
Kaufman, Claire MD	Kim, Charles Y MD	Larson, David B MBA, MD	Mercier, Gustavo MD, PhD
Min, Robert MD	Muzahir, Saima MD	Newell, Mary S MD	Parent, Ephraim E MD
Rohren, Eric MD, PhD	Russo, Suzanne MD	Schechter, Naomi MD	Schoppe, Kurt MD - CSC
Sharma, Navesh DO	Sio, Terence Tai-Weng MD, MS	Small, William MD	Spieler, Benjamin MD
Subramaniam, Rathan M MBA, MD, MPH, PhD	Toskich, Beau MD	Wang, David MD	Wright, Chadwick L MD, PhD

REFERENCES

APPENDIX A

APPENDIX B