Japanese journal of radiology · 2026
Feasibility study of streamlining radioembolization with yttrium-90 resin microspheres without lung shunt fraction measurement for colorectal liver metastasis < 7 cm.
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Lee Myungsu, Paeng Jin Chul, Lee Jong Hyuk, Suh Minseok, Han Sae-Won, Kim Hyo-Cheol
Аннотация
PURPOSE: To evaluate the feasibility of streamlining radioembolization using yttrium-90 resin microspheres without lung shunt fraction (LSF) assessment in patients with colorectal liver metastases (mCRC) < 7 cm.
MATERIALS AND METHODS: This single-center retrospective study included 32 patients with mCRC who underwent radioembolization between June 2021 and April 2025. Eligibility criteria were: primary target tumor < 7 cm, the sum of the diameters of the two largest tumors ≤ 10 cm, treatment with resin microspheres, omission of LSF measurement, and at least one follow-up imaging study. Radiation activity was prescribed based on tumor location, liver function, and clinical setting, using both single-compartment and multi-compartment dosimetry with assumption of a LSF of 5% and tumor-to-normal (TN) ratio of 3. Post-treatment Y-90 PET/CT dosimetry was performed in 15 patients. Clinical outcomes, tumor response, and treatment-related toxicity were analyzed.
RESULTS: Median administered radiation activity was 0.50 GBq (IQR, 0.41-0.82). Median mean absorbed dose (mAD) to the perfused tissue was 136 Gy, and median tumor absorbed dose (TAD) was 347 Gy with assumption of TN ratio of 3. Post-treatment PET/CT analysis (n = 15) showed a median TAD of 432 Gy with a median TN ratio of 3.9, and lung dose derived from Y-90 PET/CT image ranged from 0.12 to 0.61 Gy. The best tumor responses were complete response in 12.5%, partial response in 59.4%, and stable disease in 28.1%. One- and two-year local tumor progression-free survival rates were 70.8% and 54.1%, respectively. No patient developed radiation pneumonitis.
CONCLUSION: Streamlining radioembolization without LSF assessment appears feasible for patients with mCRC < 7 cm.
MATERIALS AND METHODS: This single-center retrospective study included 32 patients with mCRC who underwent radioembolization between June 2021 and April 2025. Eligibility criteria were: primary target tumor < 7 cm, the sum of the diameters of the two largest tumors ≤ 10 cm, treatment with resin microspheres, omission of LSF measurement, and at least one follow-up imaging study. Radiation activity was prescribed based on tumor location, liver function, and clinical setting, using both single-compartment and multi-compartment dosimetry with assumption of a LSF of 5% and tumor-to-normal (TN) ratio of 3. Post-treatment Y-90 PET/CT dosimetry was performed in 15 patients. Clinical outcomes, tumor response, and treatment-related toxicity were analyzed.
RESULTS: Median administered radiation activity was 0.50 GBq (IQR, 0.41-0.82). Median mean absorbed dose (mAD) to the perfused tissue was 136 Gy, and median tumor absorbed dose (TAD) was 347 Gy with assumption of TN ratio of 3. Post-treatment PET/CT analysis (n = 15) showed a median TAD of 432 Gy with a median TN ratio of 3.9, and lung dose derived from Y-90 PET/CT image ranged from 0.12 to 0.61 Gy. The best tumor responses were complete response in 12.5%, partial response in 59.4%, and stable disease in 28.1%. One- and two-year local tumor progression-free survival rates were 70.8% and 54.1%, respectively. No patient developed radiation pneumonitis.
CONCLUSION: Streamlining radioembolization without LSF assessment appears feasible for patients with mCRC < 7 cm.