Radioembolization with Yttrium-90 microspheres in hepatocellular carcinoma: Role and perspectives

Figure 1 Treatment with Yttrium-90 and response of infiltrative hepatocellular carcinoma. A and B: The pretreatment computed tomography (CT) showing infiltrative hepatocellular carcinoma in the IV segment with associated tumor thrombosis of the left portal branch as visualized in the arterial phase and in the portal-venous phase; C: The pretreatment angiogram carried out with selective catheterization of the left hepatic artery, arising from the left gastric artery, confirms the hypervascularization of the venous thrombus; D: The pretreatment 99mTc-MAA single photon emission computed tomography images showing the corresponding uptake of MAA in the region of interest (tumor thrombus); E and F: The CT performed 1 mo after treatment showing both a significant decrease of the enhancement of the portal venous thrombus and a reduction in the enlargement of the portal branch as a sign of response, better visualized at 1 year (G and H). Note the significant “shrinkage” of the left lobe and the compensatory hypertrophy of the contralateral hepatic lobe. 99mTc-MAA: 99mTc labeled macroaggregated albumin.