HDR-192Ir intraluminal brachytherapy in treatment of malignant obstructive jaundice

Figure 1 HDR-¹⁹²Ir (111-370 GBq) driven to the programmed locations. A: In the patient who had undergone left-lobe resection due to cholangiocarcinoma, hilar recurrence with bile duct dilation was shown by portal-phase CT scan (arrow). B: The stricture of bile duct was clearly shown by cholangiography during PTCD (arrow). C: An 8 mm×60 mm SMART stent was deployed across the stricture. D: The applicator and sham source were inserted though a 10 F internal-external drainage catheter. The dose distribution curves were obtained from the TPS (arrow).

Figure 2 Cholangiography, CT, or US before and after intraluminal brachytherapy. A: Bile duct dilation of left lobe caused by cholangiocarcinoma was shown by CT (arrow). B: Cholangiography showed hilar stricture (arrow). C: Intraluminal brachytherapy (fractional dose 7 Gy, total dose 21 Gy) was performed after an 8 mm×60 mm SMART stent insertion. D: CT follow-up 11 mo after intraluminal brachytherapy showed no progress of the tumor and no redilation of the bile duct (arrow).

Figure 3 One patient undergoing bilienterostomy and ostomy, which was shown in irradiation region in intraluminal brachy therapy. A: Cholangiography indicated that jejunum was in-vaded by the malignancy (arrow). B: Jejunum and ostomy were in the irradiation region.

Figure 4 Stent patency of the two groups.