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Y-90 Radioembolization and PD-1 Inhibitor as Neoadjuvant Treatment in Hepatocellular Carcinoma
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Yttrium 90 Radioembolization for Hepatocellular Carcinoma
1Logan Howerton, BSRS, R.T.(R)(VI) is radiologic technologist on the vascular and interventional radiology team at the University of North Carolina Hospital in Chapel Hill. She is a recent graduate of the University of North Carolina at Chapel Hill.
Radiologic Technology
|November 3, 2021
Summary
Radioembolization delivers targeted radiation therapy for liver cancer using yttrium 90 (90Y). Careful pretreatment planning, including angiography and perfusion imaging, ensures safe and effective treatment for hepatocellular carcinoma.
Area of Science:
- Oncology
- Radiology
- Nuclear Medicine
Background:
- Hepatocellular carcinoma (HCC) is a primary liver cancer.
- Radioembolization is a minimally invasive treatment for HCC.
- This therapy utilizes radioactive yttrium 90 (90Y) delivered directly to the liver vasculature.
Purpose of the Study:
- To describe the pretreatment planning process for radioembolization in HCC.
- To highlight the importance of vascular assessment and hepatic perfusion imaging.
- To ensure the safe and effective delivery of 90Y radiation therapy.
Main Methods:
- Pretreatment planning involves detailed mapping angiograms to visualize hepatic vascular structures.
- Technetium Tc 99m macroaggregated albumin (MAA) hepatic perfusion imaging is used to assess blood flow.
- This imaging helps determine the suitability and safety of 90Y administration.
Main Results:
- Angiography identifies vascular anatomy relevant to treatment delivery.
- MAA imaging quantifies hepatic perfusion and helps predict radiation dose distribution.
- These methods allow for personalized treatment planning to maximize tumor targeting and minimize off-target radiation.
Conclusions:
- Thorough pretreatment planning is essential for successful radioembolization in HCC.
- Vascular mapping and perfusion imaging are critical components of this planning process.
- These techniques ensure optimal radiation delivery to the tumor while protecting healthy liver tissue.
