Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2023 May-Jun;22(3):416-427.
doi: 10.1016/j.brachy.2023.02.004. Epub 2023 Mar 21.

First clinical implementation of Yttrium-90 Disc Brachytherapy after FDA clearance

Paul T Finger  1 , Robert Stewart  2 , Mark J Rivard  3 , Raymond J Beers  2 , Jacob Kamen  2 , Shyam Lama  2 , Kimberly J Chin  4 , Kyle Mohney  3 , Toby S Welles  3 , Wolfgang A G Sauerwein  3 , Kenneth Rosenzweig  2
Affiliations
Free article

First clinical implementation of Yttrium-90 Disc Brachytherapy after FDA clearance

Paul T Finger et al. Brachytherapy. 2023 May-Jun.
Free article

Abstract

Purpose: Herein, we study if high-dose-rate (HDR) yttrium-90 (90Y) brachytherapy could be utilized by medical physicists, radiation oncologists, and ophthalmic surgeons.

Methods and materials: Yttrium-90 (90Y) beta-emitting brachytherapy sources received United States Food and Drug Administration clearance for episcleral treatment of ocular tumors and benign growths. Dose calibration traceable to the National Institute of Standards and Technology as well as treatment planning and target delineation methods were established. Single-use systems included a 90Y-disc affixed within specialized, multifunction, handheld applicator. Low-dose-rate to high-dose-rate prescription conversions and depth-dose determinations were performed. Radiation safety was evaluated based on live exposure rates during assembly and surgeries. Clinical data for radiation safety, treatment tolerability, and local control was collected.

Results: Practice parameters for the medical physicist, radiation oncologist, and ophthalmic surgeon were defined. Device sterilizations, calibrations, assemblies, surgical methods, and disposals were reproducible and effective. Treated tumors included iris melanoma, iridociliary melanoma, choroidal melanoma, and a locally invasive squamous carcinoma. Mean calculated 90Y disc activity was 14.33 mCi (range 8.8-16.6), prescription dose 27.8 Gy (range 22-30), delivered to depth of 2.3 mm (range 1.6-2.6), at treatment durations of 420 s (7.0 min, range 219 s-773 s). Both insertion and removal were performed during one surgical session. After surgery, each disc-applicator- system was contained for decay in storage. Treatments were well-tolerated.

Conclusions: HDR 90Y episcleral brachytherapy devices were created, implementation methods developed, and treatments performed on 6 patients. Treatments were single-surgery, rapid, and well-tolerated with short-term follow up.

Keywords: (90)Y; Eye; High-dose-rate; LV Y-90 disc; Plaque; Radiation; yttrium-90.

PubMed Disclaimer

LinkOut - more resources