Techniques to Optimize Radioembolization Tumor Coverage

Abstract

Yttrium-90 (Y90) radioembolization has become a major locoregional treatment option for several primary and secondary liver cancers. Understanding the various factors that contribute to optimal tumor coverage including sphere count, embolization techniques, and catheter choice is important for all interventional radiologists while planning Y90 dosimetry and delivery. Here, we review these factors and the evidence supporting current practice paradigms.

Keywords

interventional radiology - radioembolization - yttrium-90 - liver cancer embolization

Publikationsverlauf

Artikel online veröffentlicht:
14. März 2024

• References

• 1 Bierman HR, Byron Jr RL, Kelley KH, Grady A. Studies on the blood supply of tumors in man. III. Vascular patterns of the liver by hepatic arteriography in vivo. J Natl Cancer Inst 1951; 12 (01) 107-131
• 2 Saini A, Wallace A, Alzubaidi S. et al. History and evolution of yttrium-90 radioembolization for hepatocellular carcinoma. J Clin Med 2019; 8 (01) 55
• 3 Vauthey J-N, Abdalla EK, Doherty DA. et al. Body surface area and body weight predict total liver volume in Western adults. Liver Transpl 2002; 8 (03) 233-240
• 4 Chiesa C, Mazzaglia S, Maccauro M. Spatial density and tumor dosimetry are important in radiation segmentectomy with ⁹⁰Y glass microspheres. Eur J Nucl Med Mol Imaging 2022; 49 (11) 3607-3609
• 5 Walrand S, Hesse M, Jamar F, Lhommel R. A hepatic dose-toxicity model opening the way toward individualized radioembolization planning. J Nucl Med 2014; 55 (08) 1317-1322
• 6 Pasciak AS, Abiola G, Liddell RP. et al. The number of microspheres in Y90 radioembolization directly affects normal tissue radiation exposure. Eur J Nucl Med Mol Imaging 2020; 47 (04) 816-827
• 7 Maxwell AWP, Mendoza HG, Sellitti MJ. et al. Optimizing 90Y particle density improves outcomes after radioembolization. Cardiovasc Intervent Radiol 2022; 45 (07) 958-969
• 8 Cariani E, Missale G. Immune landscape of hepatocellular carcinoma microenvironment: Implications for prognosis and therapeutic applications. Liver Int 2019; 39 (09) 1608-1621
• 9 Kim J, Jung Y. Radiation-induced liver disease: current understanding and future perspectives. Exp Mol Med 2017; 49 (07) e359
• 10 Allimant C, Kafrouni M, Delicque J. et al. Tumor targeting and three-dimensional voxel-based dosimetry to predict tumor response, toxicity, and survival after yttrium-90 resin microsphere radioembolization in hepatocellular carcinoma. J Vasc Interv Radiol 2018; 29 (12) 1662-1670.e4
• 11 Chiesa C, Mira M, Maccauro M. et al. Radioembolization of hepatocarcinoma with (90)Y glass microspheres: development of an individualized treatment planning strategy based on dosimetry and radiobiology. Eur J Nucl Med Mol Imaging 2015; 42 (11) 1718-1738
• 12 Bargellini I, Lorenzoni G, Cervelli R, Boni G, Cioni R. The efficacy of coil embolization to obtain intrahepatic redistribution in radioembolization: qualitative and quantitative analyses. Cardiovasc Intervent Radiol 2020; 43 (11) 1733-1734
• 13 Bilbao JI, Garrastachu P, Herráiz MJ. et al. Safety and efficacy assessment of flow redistribution by occlusion of intrahepatic vessels prior to radioembolization in the treatment of liver tumors. Cardiovasc Intervent Radiol 2010; 33 (03) 523-531
• 14 Borg P, Wong JJ, Lawrance N. et al. Vascular redistribution for SIRT—a quantitative assessment of treatment success and long-term analysis of recurrence and survival outcomes. J Clin Interv Radiol ISVIR 2019; 3 (02) 89-97
• 15 Jia Z, Sella DM, Wang W. Regarding “radioembolization: is prophylactic embolization of hepaticoenteric arteries necessary? A systematic review.”. Cardiovasc Intervent Radiol 2016; 39 (09) 1365-1366
• 16 Hamoui N, Minocha J, Memon K. et al. Prophylactic embolization of the gastroduodenal and right gastric arteries is not routinely necessary before radioembolization with glass microspheres. J Vasc Interv Radiol 2013; 24 (11) 1743-1745
• 17 Snoeijink TJ, Vlogman TG, Roosen J, Groot Jebbink E, Jain K, Nijsen JFW. Transarterial radioembolization: a systematic review on gaining control over the parameters that influence microsphere distribution. Drug Deliv 2023; 30 (01) 2226366
• 18 d'Abadie P, Walrand S, Goffette P. et al. Antireflux catheter improves tumor targeting in liver radioembolization with resin microspheres. Diagn Interv Radiol 2021; 27 (06) 768-773
• 19 van Roekel C, van den Hoven AF, Bastiaannet R. et al. Use of an anti-reflux catheter to improve tumor targeting for holmium-166 radioembolization-a prospective, within-patient randomized study. Eur J Nucl Med Mol Imaging 2021; 48 (05) 1658-1668