Radioembolization: Clinical Results Hepatocellular Carcinoma

Part of the Medical Radiology book series (MEDRAD)


Radioembolization is a transarterial therapy which delivers locoregional tumoricidal radiation doses to liver tumors. In this chapter, we present an overview of the available clinical data for this treatment option which is establishing its role in the management of liver tumors. Prospective analyses are needed to ascertain the benefit of radioembolization over other available therapies.


Orthotopic Liver Transplantation Portal Vein Thrombosis Intrahepatic Cholangiocarcinoma Milan Criterion Locoregional Therapy 
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  1. Bruix J, Sherman M, Llovet JM et al (2001) Clinical management of hepatocellular carcinoma. Conclusions of the Barcelona-2000 EASL conference. European Association for the Study of the Liver. J Hepatol 35(3):421–430PubMedCrossRefGoogle Scholar
  2. Carr BI, Kondragunta V, Buch SC, Branch RA (2010) Therapeutic equivalence in survival for hepatic arterial chemoembolization and yttrium 90 microsphere treatments in unresectable hepatocellular carcinoma: a Two-Cohort Study. Cancer 116(5):1305–1314Google Scholar
  3. El-Serag HB (2002) Hepatocellular carcinoma and hepatitis C in the United States. Hepatology 36(5 Suppl 1):S74–S83PubMedCrossRefGoogle Scholar
  4. Garin E, Rolland Y, Boucher E, et al (2009) First experience of hepatic radioembolization using microspheres labelled with yttrium-90 (TheraSphere): practical aspects concerning its implementation. Eur J Nucl Med Mol Imaging 37(3):453–461PubMedCrossRefGoogle Scholar
  5. Ibrahim SM, Nikolaidis P, Miller FH et al (2009) Radiologic findings following Y90 radioembolization for primary liver malignancies. Abdom Imaging 34(5):566–581PubMedCrossRefGoogle Scholar
  6. Inarrairaegui M, Martinez-Cuesta A, Rodriguez M, et al (2010) Analysis of prognostic factors after Yttrium-90 Radioembolization of advanced hepatocellular carcinoma. Int J Radiat Oncol Biol Phys 77(5):1441–1448Google Scholar
  7. Kooby DA, Egnatashvili V, Srinivasan S et al (2009) Comparison of yttrium-90 radioembolization and transcatheter arterial chemoembolization for the treatment of unresectable hepatocellular carcinoma. J Vasc Interv Radiol 21(2):224–230Google Scholar
  8. Kulik LM, Atassi B, van Holsbeeck L et al (2006) Yttrium-90 microspheres (TheraSphere(R)) treatment of unresectable hepatocellular carcinoma: downstaging to resection, RFA and bridge to transplantation. J Surg Oncol 94(7):572–586PubMedCrossRefGoogle Scholar
  9. Kulik LM, Carr BI, Mulcahy MF et al (2007) Safety and efficacy of (90)Y radiotherapy for hepatocellular carcinoma with and without portal vein thrombosis. Hepatology 47(1):71–81CrossRefGoogle Scholar
  10. Lewandowski RJ, Kulik LM, Riaz A et al (2009) A comparative analysis of transarterial downstaging for hepatocellular carcinoma: chemoembolization versus radioembolization. Am J Transplant 9(8):1920–1928PubMedCrossRefGoogle Scholar
  11. Llovet JM, Ricci S, Mazzaferro V et al (2008) Sorafenib in advanced hepatocellular carcinoma. N Engl J Med 359(4):378–390PubMedCrossRefGoogle Scholar
  12. Mazzaferro V, Regalia E, Doci R et al (1996) Liver transplantation for the treatment of small hepatocellular carcinomas in patients with cirrhosis. N Engl J Med 334(11):693–699PubMedCrossRefGoogle Scholar
  13. Rhee TK, Naik NK, Deng J et al (2008) Tumor response after yttrium-90 radioembolization for hepatocellular carcinoma: comparison of diffusion-weighted functional MR imaging with anatomic MR imaging. J Vasc Interv Radiol 19(8):1180–1186PubMedCrossRefGoogle Scholar
  14. Riaz A, Kulik L, Lewandowski RJ et al (2009a) Radiologic-pathologic correlation of hepatocellular carcinoma treated with internal radiation using yttrium-90 microspheres. Hepatology 49(4):1185–1193PubMedCrossRefGoogle Scholar
  15. Riaz A, Ryu RK, Kulik LM et al (2009b) Alpha-fetoprotein response after locoregional therapy for hepatocellular carcinoma: oncologic marker of radiologic response, progression, and survival. J Clin Oncol 27(34):5734–5742PubMedCrossRefGoogle Scholar
  16. Riaz A, Lewandowski RJ, Kulik LM et al (2009c) Complications following radioembolization with yttrium-90 microspheres: a comprehensive literature review. J Vasc Interv Radiol 20(9):1121–1130 (quiz 1131)PubMedCrossRefGoogle Scholar
  17. Riaz A, Miller F, Kulik L et al (2010) Imaging response in the primary index lesion and clinical outcomes following transarterial locoregional therapy for hepatocellular carcinoma. JAMA 303(11):1062–1069PubMedCentralPubMedCrossRefGoogle Scholar
  18. Salem R, Thurston KG (2006) Radioembolization with 90Yttrium microspheres: a state-of-the-art brachytherapy treatment for primary and secondary liver malignancies: Part 1: Technical and methodologic considerations. J Vasc Interv Radiol 17(8):1251–1278PubMedCrossRefGoogle Scholar
  19. Salem R, Lewandowski RJ, Mulcahy MF et al (2010) Radioembolization for hepatocellular carcinoma using Yttrium-90 microspheres: a comprehensive report of long-term outcomes. Gastroenterology 138(1):52–64PubMedCrossRefGoogle Scholar
  20. Sangro B, Bilbao JI, Boan J et al (2006) Radioembolization using 90Y-resin microspheres for patients with advanced hepatocellular carcinoma. Int J Radiat Oncol Biol Phys 66(3):792–800PubMedCrossRefGoogle Scholar
  21. Therasse P, Arbuck SG, Eisenhauer EA et al (2000) New guidelines to evaluate the response to treatment in solid tumors. J Natl Cancer Inst 92(3):205–216PubMedCrossRefGoogle Scholar

Copyright information

© Springer-Verlag Berlin Heidelberg 2012

Authors and Affiliations

  1. 1.Division of Interventional Radiology, Department of RadiologyNorthwestern UniversityChicagoUSA
  2. 2.Division of Hepatology, Department of MedicineNorthwestern UniversityChicagoUSA
  3. 3.Division of Interventional Radiology, Department of Radiology, Medicine and SurgeryNorthwestern UniversityChicagoUSA

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