Role of Interventional Oncology in the Management of Neuroendocrine Tumors: 2026 Update.

PURPOSE OF REVIEW: Summarize recent advances in interventional oncology for the management of neuroendocrine tumor liver metastases (NETLMs), with a focus on evolving evidence for embolization and ablation, integration with systemic therapies, and emerging approaches.

RECENT FINDINGS: Recent studies have strengthened the role of liver-directed therapies within multidisciplinary NET care. Long-term data supports transarterial chemoembolization as an effective and repeatable line of therapy. Improved dosimetry techniques are refining radioembolization's role in NETLM treatment, improving outcomes while limiting long-term toxicities. Synergistic treatment combinations have demonstrated promising efficacy. New evidence for focal therapies, including radiation segmentectomy and histotripsy, may expand options for solitary and oligometastatic disease. Concurrent biopsy and molecular profiling increasingly inform treatment decisions. Interventional radiologists play an increasingly important role in NETLM management by providing tailored and targeted liver-directed therapies, improving patient outcomes, delaying the start of systemic therapies, and integrating with NET treatment plans. Ongoing studies will further define optimal treatment sequencing and patient selection while expanding interventional treatment options.