Hepatic volume changes post-selective internal radiation therapy with ⁹⁰ Y microspheres.

Area of Science:

• Hepatobiliary surgery
• Interventional radiology
• Oncology

Background:

• Selective internal radiation therapy (SIRT) using ⁹⁰Y microspheres is an alternative to portal vein embolization for inducing future liver remnant (FLR) hypertrophy.
• This technique aims to reduce postoperative morbidity and increase surgical resection eligibility for liver malignancies.
• Unlike portal vein embolization, SIRT also treats liver tumors and mitigates progression during hypertrophy.

Purpose of the Study:

• To evaluate hepatic volume changes following SIRT with ⁹⁰Y microspheres.
• To assess the efficacy of SIRT in inducing FLR hypertrophy for patients with right liver lobe malignancy.

Main Methods:

• Retrospective analysis of 29 patients with right liver lobe malignancy treated with SIRT between August 2012 and November 2016.
• Liver volumes were measured using CT or MRI before treatment and at 3, 6, and 12 months post-SIRT.

Main Results:

• A mean increase in FLR volume of 37.2% at 3 months, 42.6% at 6 months, and 63.5% at 12 months was observed.
• The whole liver volume showed a mean decrease of -13.3% at 12 months.
• Primary liver malignancies (HCC, cholangiocarcinoma) and metastases (colorectal, ampullary) were present in the study cohort.

Conclusions:

• SIRT of the right liver lobe effectively induces compensatory hypertrophy of the left liver lobe (FLR).
• The findings support the use of SIRT in selected patients with right liver lobe malignancy to facilitate liver resection.