Radioembolisation of hepatocellular carcinoma patients using ⁹⁰Y-labelled microspheres: towards a diffusion of the technique?

Excerpt

Radioembolisation of patients with liver carcinoma using microspheres labelled with ⁹⁰Y is increasingly being used with promising results. Although more complex than ¹³¹I-Lipiodol therapy, this technique is associated with fewer radioprotection constraints along with a better safety profile, as it is always preceded by diagnostic angiography and hepatic perfusion scintigraphy using ^99mTc-labelled macroaggregated albumin (MAA). Two different products are currently available: glass and resin microspheres. Glass microspheres, which present a low embolic potential (25 ± 10 μm in diameter; 2 500 Bq per sphere; available activities of 3, 5, 7, 10, 15 and 20 GBq), were initially developed for treating hepatocellular carcinoma (HCC) patients and can also be used in the case of portal vein thrombosis (TheraSphere, MDS Nordion, Kanata, ON, Canada). In contrast, resin microspheres exhibit a more marked embolic potential (35 ± 10 μm in diameter; 500 Bq per sphere; available activity of 3 GBq) and were initially developed for treating hepatic metastases (SIR-Spheres, SIRTeX Medical Limited, Sydney, Australia), with portal vein thrombosis being a relative contraindication to their use. Due to these differences, the efficacy and toxicity profiles of both products may be different, and it is thus important to analyse separately and compare the results obtained with glass and resin microspheres. …