Download PDF
Semin intervent Radiol 2024; 41(01): 016-019
DOI: 10.1055/s-0043-1778659
Review Article

Techniques to Optimize Radioembolization Tumor Coverage

M. Kasim Fassia
1   Division of Interventional Radiology, Department of Radiology, Weill Cornell Medicine, New York, New York
,
Resmi Ann Charalel
1   Division of Interventional Radiology, Department of Radiology, Weill Cornell Medicine, New York, New York
2   Department of Population Health Sciences, Weill Cornell Medicine, New York, New York
› Author Affiliations
› Further Information
Also available at
    Permissions and Reprints

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


Publication History

Article published online:
14 March 2024

© 2024. Thieme. All rights reserved.

Thieme Medical Publishers, Inc.
333 Seventh Avenue, 18th Floor, New York, NY 10001, USA

 

  • 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
    PubMedSearch in Google Scholar
  • 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
    CrossrefPubMedSearch in Google Scholar
  • 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
    CrossrefPubMedSearch in Google Scholar
  • 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
    CrossrefPubMedSearch in Google Scholar
  • 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
    CrossrefPubMedSearch in Google Scholar
  • 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
    CrossrefPubMedSearch in Google Scholar
  • 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
    CrossrefPubMedSearch in Google Scholar
  • 8 Cariani E, Missale G. Immune landscape of hepatocellular carcinoma microenvironment: Implications for prognosis and therapeutic applications. Liver Int 2019; 39 (09) 1608-1621
    CrossrefPubMedSearch in Google Scholar
  • 9 Kim J, Jung Y. Radiation-induced liver disease: current understanding and future perspectives. Exp Mol Med 2017; 49 (07) e359
    CrossrefPubMedSearch in Google Scholar
  • 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
    CrossrefPubMedSearch in Google Scholar
  • 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
    CrossrefPubMedSearch in Google Scholar
  • 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
    CrossrefPubMedSearch in Google Scholar
  • 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
    CrossrefPubMedSearch in Google Scholar
  • 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
    Thieme ConnectPubMedSearch in Google Scholar
  • 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
    CrossrefPubMedSearch in Google Scholar
  • 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
    CrossrefPubMedSearch in Google Scholar
  • 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
    CrossrefPubMedSearch in Google Scholar
  • 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
    CrossrefPubMedSearch in Google Scholar
  • 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
    CrossrefPubMedSearch in Google Scholar