Liver radioembolization : from dosimetry to clinical effects

Selective internal radiation therapy (SIRT) is part of the treatment strategy of liver tumors. SIRT can be performed using resin or glass microspheres, demonstrating different chemico-physical and radioactive properties. Post therapy imaging using 90Y PET/CT can evaluate the deposition of the tumor-absorbed dose and predict the patient outcome. 90Y PET/CT can also precisely evaluate the heterogeneous distribution of the absorbed dose within the tumor by calculating a equivalent uniform dose (EUD). Tumor EUD is strongly correlated with survival of patients and reunifies the absorbed doses between resin and glass microspheres as well as those from external radiation beam therapy. Moreover, pre-therapy imaging using 99mTc macroaggregated albumin (MAA) can optimize the activity planning, predicting with high accuracy the absorbed dose to the healthy liver. Furthermore, the tumor targeting can be optimized using a specific catheter during the arteriography, named antireflux catheter (ARC). Using ARC, the absorbed dose can be significantly increased in neuroendocrine and HCC tumors, hence, increasing the tumor control probability.
(MED - Sciences médicales) -- UCL, 2022