Evolution of radioembolization in treatment of hepatocellular carcinoma: A pictorial review

Frank H. Miller*, Camila Lopes Vendrami, Ahmed Gabr, Jeanne M. Horowitz, Linda C. Kelahan, Ahsun Riaz, Riad Salem, Robert J. Lewandowski

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

1 Scopus citations

Abstract

Transarterial radioembolization (TARE) with yttrium 90 has increasingly been performed to treat hepatocellular carcinoma (HCC). TARE was historically used as a palliative lobar therapy for patients with advanced HCC beyond surgical options, ablation, or transarterial chemoembolization, but recent advancements have led to its application across the Barcelona Clinic Liver Cancer staging paradigm. Newer techniques, termed radiation lobectomy and radiation segmentectomy, are being performed before liver resection to facilitate hypertrophy of the future liver remnant, before liver transplant to bridge or downstage to transplant, or as a definite curative treatment. Imaging assessment of therapeutic response to TARE is challenging as the intent of TARE is to deliver local high-dose radiation to tumors through microembolic microspheres, preserving blood flow to promote radiation injury to the tumor. Because of the microembolic nature, early imaging assessment after TARE cannot rely solely on changes in size. Knowledge of the evolving methods of TARE along with the tools to assess posttreatment imaging and response is essential to optimize TARE as a therapeutic option for patients with HCC.

Original languageEnglish (US)
Pages (from-to)1802-1818
Number of pages17
JournalRadiographics
Volume41
Issue number6
DOIs
StatePublished - Oct 2021

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging

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