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European Journal of Nuclear Medicine and Molecular Imaging

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25-10-2022 | Hepatocellular Carcinoma | Original Article

Defining textbook outcome for selective internal radiation therapy of hepatocellular carcinoma: an international expert study

Authors: Jules Gregory, Lambros Tselikas, Caroline Allimant, Thierry de Baere, Irene Bargellini, Jon Bell, José Ignacio Bilbao, Antoine Bouvier, Julius Chapiro, Carlo Chiesa, Thomas Decaens, Alban Denys, Rafael Duran, Julien Edeline, Etienne Garin, Julien Ghelfi, Thomas Helmberger, Farah Irani, Marnix Lam, Robert Lewandowski, David Liu, Romaric Loffroy, David C. Madoff, Charles Mastier, Riad Salem, Bruno Sangro, Daniel Sze, Valérie Vilgrain, Michael Vouche, Boris Guiu, Maxime Ronot

Published in: European Journal of Nuclear Medicine and Molecular Imaging | Issue 3/2023

Abstract

Background

A textbook outcome (TO) is a composite indicator covering the entire intervention process in order to reflect the “ideal” intervention and be a surrogate for patient important outcomes. Selective internal radiation therapy (SIRT) is a complex multidisciplinary and multistep intervention facing the challenge of standardization. This expert opinion-based study aimed to define a TO for SIRT of hepatocellular carcinoma.

Methods

This study involved two steps: (1) the steering committee (4 interventional radiologists) first developed an extensive list of possible relevant items reflecting an optimal SIRT intervention based on a literature review and (2) then conducted an international and multidisciplinary survey which resulted in the final TO. This survey was online, from February to July 2021, and consisted three consecutive rounds with predefined settings. Experts were identified by contacting senior authors of randomized trials, large observational studies, or studies on quality improvement in SIRT. This study was strictly academic.

Results

A total of 50 items were included in the first round of the survey. A total of 29/40 experts (73%) responded, including 23 interventional radiologists (79%), three nuclear medicine physicians (10%), two hepatologists, and one oncologist, from 11 countries spanning three continents. The final TO consisted 11 parameters across six domains (“pre-intervention workup,” “tumor targeting and dosimetry,” “intervention,” “post-⁹⁰Y imaging,” “length of hospital stay,” and “complications”). Of these, all but one were applied in the institutions of > 80% of experts.

Conclusions

This multidimensional indicator is a comprehensive standardization tool, suitable for routine care, clinical round, and research.

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Title: Defining textbook outcome for selective internal radiation therapy of hepatocellular carcinoma: an international expert study
Authors: Jules Gregory
Lambros Tselikas
Caroline Allimant
Thierry de Baere
Irene Bargellini
Jon Bell
José Ignacio Bilbao
Antoine Bouvier
Julius Chapiro
Carlo Chiesa
Thomas Decaens
Alban Denys
Rafael Duran
Julien Edeline
Etienne Garin
Julien Ghelfi
Thomas Helmberger
Farah Irani
Marnix Lam
Robert Lewandowski
David Liu
Romaric Loffroy
David C. Madoff
Charles Mastier
Riad Salem
Bruno Sangro
Daniel Sze
Valérie Vilgrain
Michael Vouche
Boris Guiu
Maxime Ronot
Publication date: 25-10-2022
Publisher: Springer Berlin Heidelberg
Keywords: Hepatocellular Carcinoma
Hepatocellular Carcinoma
Published in: European Journal of Nuclear Medicine and Molecular Imaging / Issue 3/2023
Print ISSN: 1619-7070
Electronic ISSN: 1619-7089
DOI: https://doi.org/10.1007/s00259-022-06002-5

At a glance: The STEP trials

Springer Medicine

Defining textbook outcome for selective internal radiation therapy of hepatocellular carcinoma: an international expert study

Abstract

Background

Methods

Results

Conclusions

At a glance: The STEP trials

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

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