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This is a guest blog by Frank Nijsen (CSO of Quirem Medical)
The toolbox of an oncologists who is faced with treating liver cancer, is still limited. Fortunately, a new tool will be added shortly to target advanced unresectable liver tumours: microscopic beads loaded with the radioactive isotope holmium-166. These so-called microspheres are brought onto the market by Quirem Medical (Deventer, the Netherlands) as QuiremSpheres®. Recently, QuiremSpheres® was named a top 5 Dutch medical technology innovation.
QuiremSpheres® consists of millions of tiny microspheres. In fact, the microspheres are smaller than a third of the diameter of human hair. Nevertheless, their impact on liver tumors can be huge. The mode of action is twofold:
1) once introduced in the bloodstream to the liver tumours, the microspheres block the hair vessels supplying oxygen and nutrients to the tumours (embolization) and
2) beta-radiation, emitted by the radioactive holmium-166, kills tumour cells from close range (radiotherapy).
It is because of this dual action that the treatment is called radioembolization. Various clinical studies have shown the efficacy of radioembolization for treatment of liver tumors while patients only suffer relatively mild side-effects.
QuiremSpheres® microspheres are based on more than 20 years of research and development at the University Medical Center in Utrecht (UMCU), the Netherlands. 15 years ago, radioembolization was already an existing, but largely unknown, treatment method for liver cancer. The researchers at the UMC Utrecht wanted not only to promote the usage of radioembolization, but also develop a new type of microsphere with unique imaging advantages. And they succeeded. The microspheres that were developed cannot only be imaged with SPECT imaging, but also with MRI. By means of these imaging possibilities, the treating clinician can follow the microspheres after they have been injected in the liver artery and assure that the microspheres actually reach the tumours. In addition, Quirem Medical provides proprietary software to precisely calculated the dose that was delivered to the tumour and to the healthy liver tissue.
After the production of the ‘cold’ holmium-165 microspheres, a vial containing 33 million microspheres is activated by neutron bombardment in a nuclear reactor. The resulting active holmium-166 microspheres are then transported to a hospital for implantation into the patient. The limited half-life of holmium 166 (26.8 hours) means that good reactor-to-hospital logistics is of key importance.
Curious? Read more about this application in our application note 'Microspheres for liver cancer treatment' using Bronkhorst EL-FLOW Select thermal mass flow meters and the MASS-VIEW flow meters.
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