dose and tissue level was observed in liver, kidney, and spleen. Non-linear disposition is suggested there. DDFP lung concen- trations were consistently higher than in any other tissue. These data suggest that lung DDFP levels may cause adverse effects and limit DDFPe dose. Conclusion: DDFP promptly reaches the brain and concen- trations rise in all tissues with multiple doses. Future studies will develop a dosing regimen to optimize a wide range of therapeutic effects in ischemic states and minimize toxicity. Educational Exhibit Abstract No. 363 Protecting the runoff during lower extremity arterial interventions using embolic protection devices A. Yaghoubian, M. Ugas, L.R. Wilkins, S.S. Sabri, J. F. Angle; Radiology, UVA, Charlotessville, VA Learning Objectives: 1. Identifying lesions and procedures at risk for distal embolization. 2. Discussing the risks and benefits in using protection devices during lower limb interventions. Background: Embolic protection devices were first introduced in 1990 to prevent cerebral infarcts during carotid artery stenting. The routine use of protection devices significantly decreased stroke risk and have also been implemented in other vascular beds. Percutaneous endovascular lower limb arterial interventions are increasingly being done for the treatment of peripheral arterial disease. Identifying vulnerable lesions and high risk procedures more likely to cause distal embolization is important to minimize periprocedural complications, maximize procedural success and minimize re-interventions. Clinical Findings/Procedure Details: Distal embolization during lower extremity interventions is a variably reported complication with incidence varying from 1.5% to 19% for clinically significant embolic events depending on the case series of patients. Unstable lesions more at risk for distal embolization include intervening on chronic total occlusive disease, in-stent lesions, complex long complex lesions, heavily calcified lesions, ulcerated friable atheromatous plaque or thrombus-laden/occluded bypass grafts. High risk procedures include catheter-directed pharmacomechanical thrombolysis, use of atherectomy devices and recanalization of occluded stents and bypass grafts. Subclinical microemboli are near ubiquitously dislodged even during simplest interventions including crossing the target lesion with a wire or during balloon/stent angioplasty. It is important to note that protec- tion devices are not complication free nor do they completely negate the risk of distal embolization. The profile of individual devices can limit the crossability past certain lesions which in of itself may propagate distal emboli during manipulation or allow emboli to pass unhindered if there is an incomplete seal against the vessel. Conclusion and/or Teaching Points: Embolic protection devices can prevent embolic debris during lower limb interven- tions. Knowledge of at-risk lesions and interventions can assist the inteventionalist in choosing to employ these devices on a case-by-case basis. Abstract No. 364 Hepatic Yttrium-90 radioembolization for neuroendocrine malignancy: a meta-analysis Z. Devcic 1 , J. Rosenberg 1 , A. Braat 2 , T. Techasith 1 , A. Banerjee 1 , D.Y. Sze 1 , M.G. Lam 2 ; 1 Department of Radiology, Stanford University Medical Center, Stanford, CA; 2 Department of Radiology and Nuclear Medicine, University Medical Center Utrecht, Utrecht, Netherlands Purpose: Yttrium-90 radioembolization (RE) has emerged as a favored treatment in patients with liver dominant neuroen- docrine metastases (mNET). In the absence of level I data, the aim of this study was to evaluate the efficacy of this modality in a meta-analysis of the published literature. Materials and Methods: A comprehensive review protocol screened all reports in the literature. Strict selection criteria were applied to ensure consistency among the selected studies: human subjects, response or survival data, resin microspheres, 45 patients, not a review article, abstract, or presentation, English language, and separate and complete data for mNET if the study included multiple tumor types. Selected studies were critically appraised on 54 study criteria, in accordance with the Research Reporting Standards for RE. Response data at 3 months (RECIST) were extracted and analyzed using both fixed and random-effects meta-analyses. Results: A total of 145 studies were screened; 11 were selected, totaling 428 procedures (408 patients). Funnel plots showed no evidence of publication bias (p¼0.876). Critical appraisal revealed an average of 71% of desired criteria included in selected studies. Very high between-study heterogeneity (I- square¼75-78%; po0.0001) ruled out a fixed-effects model. The random-effects weighted average response rate (CR and PR) was 48% (95% CI: 35% - 62%) and weighted average disease control rate (CR, PR and SD) was 86% (95% CI: 74% - 92%). Percentage of patients with islet cell mNET was margin- ally associated with poorer response (p¼0.063), accounting for approximately 22% of the heterogeneity among studies. Per- centage of carcinoid histology, however, did not have a significant effect (p¼0.228), although histology data were incompletely provided by the studies. The percent response correlated with median survival (R¼0.85; p¼0.008). Conclusion: This meta-analysis confirms RE to be a valuable treatment option for patients with mNET. The pooled data demonstrated a weighted response rate of 48% and a disease control rate of 86%, as well as an increase in survival for patients responding to therapy. Most studies were incompletely compliant with reporting standards. Educational Exhibit Abstract No. 365 How to determine absorbed dose following radioembolization using Y90 PET/CT: a clinician’s guide J.L. Kao, A.C. Bourgeois, T. Chang, L. Findeiss, J. McElmurray, Y.C. Bradley, A. Pasciak; Univ of Tennessee-EPS, Knoxville, TN Learning Objectives: The process of converting Yttrium-90 (Y90) PET/CT images into 3D absorbed dose maps will be Posters and Exhibits ’ JVIR S162 Posters and Exhibits