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Updated: Feb 13, 2026
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A "Patient-Like" Orthotopic Syngeneic Mouse Model of Hepatocellular Carcinoma Metastasis
Published on: October 24, 2015
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Ultra-selective radiation segmentectomy for early-stage hepatocellular carcinoma
Christopher D Malone1, Tharun Alamuri2, Sam Meiselman3
1Mallinckrodt Institute of Radiology, Washington University School of Medicine, St Louis, MO, United States.
JHEP Reports : Innovation in Hepatology
|February 12, 2026
Summary
Ultra-selective radiation segmentectomy (uRS) using glass 90Y-microspheres is a safe and effective treatment for early-stage hepatocellular carcinoma (HCC), achieving high response rates with minimal liver impact. Dosimetry confirms dose-response relationships, highlighting the importance of tumor coverage for successful outcomes.
Area of Science:
- Interventional Radiology
- Hepatobiliary Oncology
- Nuclear Medicine
Background:
- Radiation segmentectomy (RS) is an emerging curative-intent therapy for early-stage hepatocellular carcinoma (HCC) when resection or ablation is not feasible.
- Ultra-selective RS targets <1 Couinaud segment using glass 90Y-radioembolization delivered to vessels beyond parent segmental arteries.
Purpose of the Study:
- To evaluate the safety, efficacy, and dosimetric correlates of ultra-selective RS for early-stage HCC.
- To assess tumor response, progression-free survival, and liver function after ultra-selective RS.
Main Methods:
- Retrospective study of 38 patients with 42 early-stage HCCs treated with ultra-selective RS using glass 90Y-microspheres.
- Voxel-based dosimetry using 90Y SPECT/CT; tumor response assessed by modified RECIST and explant pathology.
- Longitudinal tracking of albumin-bilirubin (ALBI) scores.
Main Results:
- 87% complete response (CR) achieved; median local progression-free survival not reached.
- Tumor D95 >300 Gy predicted CR (97% vs. 0%; p <0.001), AUC of 0.98.
- Over 82% of patients retained or improved ALBI grade; 69% complete necrosis in explant data.
Conclusions:
- Ultra-selective RS is a feasible and liver-sparing therapy for early-stage HCC.
- Voxel-based dosimetry confirms dose-response relationships and the importance of tumor coverage.
- uRS can serve as definitive therapy or a bridge to transplantation with low rates of liver function decline.
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