Selective internal radiation therapy segmentectomy: A new minimally invasive curative option for primary liver malignancies?

Figure 1 72-year-old man with hepatocellular carcinoma unfit for surgery due to comorbidities (alpha-fetoprotein 2235 ng/mL). A: Computed tomography (CT) showing large hepatocellular carcinoma nodule (7 cm) located in S3; B and C: Angiography and cone beam CT demonstrating superselective catheterization of the segmental S3 artery with perfused nodule; D-F: Single-photon emission tomography combined with CT showing 99mTc-MAA uptake into S3 without uptake in the remaining liver parenchyma or other organs.

Figure 2 Same patient of figure 1. A and B: Post-transarterial radioembolization, axial and coronal positron emission tomography-computed tomography (CT) views of the Y-90 dose distribution demonstrating high uptake in the tumor without any nontarget activity; C and D: Four-months follow-up CT scan (axial and coronal view) showing necrotic nodule with segmental S3 atrophy (alpha-fetoprotein 7 ng/mL).