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Trans-arterial Radioembolization Dosimetry in 2022

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  • Interventional Oncology
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Abstract

Trans-arterial radioembolization is currently performed using 90Y-loaded glass or resin microspheres and also using 166Ho-loaded microspheres. The goal of this review is to present dosimetry and radiobiology concepts, the different dosimetry approaches available (simulation-based dosimetry and post-treatment dosimetry), main confounding factors as main clinical dosimetry results provided during the last decade for both hepatocellular carcinoma (HCC) and metastases of colorectal carcinoma (mCRC). Based on the different number of microspheres or different isotope used, radiobiology of the three devices is different, meaning that tumouricidal doses and maximal tolerated doses are different. Tumouricidal doses described for HCCs were 100–120 grays (Gy) with 90Y resin microspheres and 205 Gy with 90Y glass microspheres. For mCRC, it is 39–60 with 90Y resin microspheres, 139 Gy with 90Y glass microspheres and 90 Gy with 166Ho microspheres. An impact of tumoural doses with overall survival has also been reported. Personalised dosimetry has been developed and is now recommended by several international expert groups. Level-one evidence of the major impact of personalised dosimetry on response and overall survival in HCC is now available, bringing a new standard approach for TARE in clinical practice as well as for trial design.

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  1. Department of Nuclear Medicine, Centre de Lutte Contre le Cancer Eugène Marquis, 35042, Rennes, France

    Etienne Garin & Xavier Palard

  2. Department of Radiology, St-Eloi University Hospital, 34295, Montpellier, France

    Boris Guiu

  3. Department of Oncology, Centre de Lutte Contre le Cancer Eugène Marquis, 35042, Rennes, France

    Julien Edeline

  4. Department of Radiology, Centre de Lutte Contre le Cancer Eugène Marquis, 35042, Rennes, France

    Yan Rolland

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Etienne Garin is consultant for Boston Scientific and reports receiving a grant, personal fees, and non-financial support from Boston Scientific. Boris Guiu is consultant for Boston Scientific declares that he has no conflict of interest. Julien Edeline reports receiving a grant from Boston Scientific during the conduct of the study; personal fees from Boston Scientific, Bayer, Roche, Eisai, Merck Sharpe & Dohme, AstraZeneca and Ipsen; grants and personal fees from Bristol Myers Squibb; and non-financial support from Amgen, outside the submitted work. Yan Rolland reports receiving a grant from Boston Scientific.

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Garin, E., Guiu, B., Edeline, J. et al. Trans-arterial Radioembolization Dosimetry in 2022. Cardiovasc Intervent Radiol 45, 1608–1621 (2022). https://doi.org/10.1007/s00270-022-03215-x

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