Optimizing Yttrium-90 Radioembolization Dosimetry for Hepatocellular Carcinoma: A Korean Perspective

Area of Science:

• Hepatobiliary Oncology
• Interventional Radiology
• Radiation Oncology

Background:

• Yttrium-90 transarterial radioembolization (TARE) is a key treatment for hepatocellular carcinoma (HCC).
• Clinical guidelines increasingly recommend TARE for HCC management.
• Advancements in dosimetry significantly enhance TARE efficacy and patient outcomes.

Purpose of the Study:

• To review the critical aspects of Yttrium-90 transarterial radioembolization (TARE) dosimetry for hepatocellular carcinoma (HCC).
• To explore dose-response relationships and strategies for mitigating treatment toxicities.
• To discuss the evolving clinical applications and future research directions in TARE.

Main Methods:

• Review of single- and multi-compartment dosimetry models in TARE.
• Comparison of resin and glass microsphere properties and their impact on dosimetry.
• Analysis of dose-response relationships for tumor control and organ toxicity.

Main Results:

• Personalized dosimetry and multi-compartment modeling improve tumor response in TARE for HCC.
• Higher tumor-absorbed doses correlate with better oncologic control.
• Careful dose adjustment is vital to prevent hepatotoxicity and radiation pneumonitis.

Conclusions:

• TARE dosimetry is essential for optimizing HCC treatment, balancing efficacy and safety.
• Strategies to mitigate liver and lung toxicity are critical for successful TARE.
• Further research is needed to refine TARE dose optimization protocols for diverse patient populations.