TY - JOUR
T1 - Impact of Injection Technique on Microsphere Distribution During Transarterial Radioembolization in a Successively Bifurcating In Vitro Model
AU - Snoeijink, Tess J.
AU - van der Hoek, Jan L.
AU - van den Brekel, Anne
AU - van Wolfswinkel, Gerhard
AU - Janssen, Marcel J.R.
AU - Groot Jebbink, Erik
AU - Nijsen, J. Frank W.
N1 - Publisher Copyright:
© 2025 The Authors. Published by Elsevier Inc. on behalf of American Society for Radiation Oncology.
PY - 2026/2
Y1 - 2026/2
N2 - Purpose: This study aimed to experimentally investigate how injection technique affects the distribution of microspheres during transarterial radioembolization in a successively bifurcating in vitro model.Methods and Materials: A symmetrical phantom, bifurcating 3 times into 8 outlets, was incorporated into a flow circuit. A blood-mimicking fluid was pumped through the phantom using a physiological representative waveform. A microcatheter was placed into the lumen of the phantom, and holmium-165 microspheres were administered with a conventional administration device and a newly designed controlled administration device, containing a rotating syringe to keep the microspheres in suspension during administration. Two clinicians performed manual injections to establish clinically relevant injection rates. Then, different injection profiles were tested using syringe pumps: pulsed vs continuous injections (24 mL/min), and reduced continuous injection rates (10 and 5 mL/min). Microspheres were collected at each outlet and their distribution over the 8 outlets was analyzed.Results: Continuous high injection rates led to more homogeneous radial distributions of microspheres over the right side of the phantom (outlet 5-8 received 16.5%-23.1% of the microspheres per outlet) compared with the clinically standard used pulsed injections (outlet 5-8 received 11.3%-40.1% of the microspheres per outlet). In contrast, reduced continuous injection rates led to more selective distributions (outlet 5-8 received 2.5%-68.8% of the microspheres at 10 mL/min and 1.0%-80.0% at 5 mL/min).Conclusions: Injection technique strongly influences the distribution of microspheres. During high continuous injections, more mixing between microspheres and blood-mimicking fluid was observed. This led to more uniform radial microsphere distributions, creating a more predictive setting for transarterial radioembolization.
AB - Purpose: This study aimed to experimentally investigate how injection technique affects the distribution of microspheres during transarterial radioembolization in a successively bifurcating in vitro model.Methods and Materials: A symmetrical phantom, bifurcating 3 times into 8 outlets, was incorporated into a flow circuit. A blood-mimicking fluid was pumped through the phantom using a physiological representative waveform. A microcatheter was placed into the lumen of the phantom, and holmium-165 microspheres were administered with a conventional administration device and a newly designed controlled administration device, containing a rotating syringe to keep the microspheres in suspension during administration. Two clinicians performed manual injections to establish clinically relevant injection rates. Then, different injection profiles were tested using syringe pumps: pulsed vs continuous injections (24 mL/min), and reduced continuous injection rates (10 and 5 mL/min). Microspheres were collected at each outlet and their distribution over the 8 outlets was analyzed.Results: Continuous high injection rates led to more homogeneous radial distributions of microspheres over the right side of the phantom (outlet 5-8 received 16.5%-23.1% of the microspheres per outlet) compared with the clinically standard used pulsed injections (outlet 5-8 received 11.3%-40.1% of the microspheres per outlet). In contrast, reduced continuous injection rates led to more selective distributions (outlet 5-8 received 2.5%-68.8% of the microspheres at 10 mL/min and 1.0%-80.0% at 5 mL/min).Conclusions: Injection technique strongly influences the distribution of microspheres. During high continuous injections, more mixing between microspheres and blood-mimicking fluid was observed. This led to more uniform radial microsphere distributions, creating a more predictive setting for transarterial radioembolization.
UR - https://www.scopus.com/pages/publications/105023898458
U2 - 10.1016/j.adro.2025.101954
DO - 10.1016/j.adro.2025.101954
M3 - Article
AN - SCOPUS:105023898458
SN - 2452-1094
VL - 11
JO - Advances in Radiation Oncology
JF - Advances in Radiation Oncology
IS - 2
M1 - 101954
ER -