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Updated: Oct 31, 2025
Y-90 Radioembolization and PD-1 Inhibitor as Neoadjuvant Treatment in Hepatocellular Carcinoma
Published on: May 24, 2024
Lung Shunt Reduction for Yttrium-90 Radioembolization: Chemoembolization Versus Radioembolization
Hyo-Cheol Kim1, Jin Woo Choi2, Myungsu Lee2
1Department of Radiology, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Republic of Korea; angiointervention@gmail.com.
Aim:
To evaluate the efficacy of chemoembolization versus radioembolization in reducing lung shunt fraction (LSF) in patients with hepatocellular carcinoma (HCC).
Patients And Methods:
In this retrospective study, from March 2012 to January 2021, 457 patients with HCC underwent planning angiography and 99mTc-macroaggregated albumin imaging for possible yttrium-90 radioembolization. Ten patients underwent radioembolization, and seven patients underwent conventional chemoembolization for LSF reduction, and a second 99mTc-macroaggregated albumin imaging was obtained approximately 1 month later. LSF under both procedures was compared with the Mann-Whitney U-test and the Wilcoxon signed-rank test.
Results:
In the radioembolization group, the mean first and second LSF were 13.0±6.9% and 20.9±9.6%, respectively (p=0.059); after radioembolization, LSF was lower in three patients but higher in seven patients. In the chemoembolization group, the mean first and second LSF were 26.1±17.3% and 8.7±5.5%, respectively (p=0.018); after chemoembolization, LSF was reduced in all seven patients.
Conclusion:
Chemoembolization appears to be more effective in reducing LSF within 1 month compared with radioembolization.
