Same-day Y90 radioembolization with resin microspheres in patients with large liver tumor ≥ 5 cm

To detail the process of resin-based same-day radioembolization for treating large liver cancers ≥ 5 cm and to evaluate its safety and preliminary outcomes.

Materials and Methods:

This single-center retrospective study included 76 patients with malignant liver tumors who underwent same-day radioembolization between January 2022 and December 2023. Macroaggregated albumin (MAA) scintigraphy and SPECT/CT were initiated within 1 hour following the planning angiography. Based on the angiography and nuclear medicine images, operators determined the required number and activity of vials. Daughter vials were dispensed from a pre-ordered mother vial and delivered to the angiography room within 1 hour after completing MAA scintigraphy and SPECT/CT, while operators were cannulating the first target artery. The procedure time and outcomes were analyzed based on electronic medical records.

Results:

Among 80 patients who were scheduled to receive same-day radioembolization, 4 were excluded because of a high estimated lung dose, leading to the rejection of the radioembolization procedure. The remaining 76 patients, who had a mean tumor size of 9.4 cm, were treated with resin microspheres. The treatment involved a mean activity of 2.8 GBq targeting an average of 3.2 vessels. The median time interval from the initiation of planning angiography to the completion of radioembolization was 215 minutes on average. Radioembolization proceeded as planned for all patients. There were no instances of symptomatic radiation pneumonitis or radiation-induced liver disease.

Conclusion:

Same-day radioembolization with resin microspheres is feasible and safe for large liver tumors ≥ 5cm.