Copyright ©The Author(s) 2015.
World J Hepatol. Apr 18, 2015; 7(5): 738-752
Published online Apr 18, 2015. doi: 10.4254/wjh.v7.i5.738
Table 1 Characteristics of commercially available Yttrium-90-microspheres for transarterial radioembolization (modified from Sangro et al[72])
Isotope 90YAttached to the surfaceIncorporated into the glass matrix
Half-life (h)64.164.1
Microsphere materialResinGlass
Microsphere diameter (μm)20-6020-30
Average size (μm)32.525
Approximate activity per microsphere (Bq)502500
Number of microspheres per 3 GBq40-80 × 1061.2 × 106
Specific gravity (g/mL)1.63.6
Activity per commercially available vial (GBq)3 (can be divided)3, 5, 7, 10, 15, 20
Activity calculationCompartmental MIRD macrodosimetry or empirical formula based on liver volume and tumor volumeNon-compartmental MIRD macrodosimetry
Estimated dose to the central vein area (Gy) in the montecarlo simulation35958
Embolic effectModerateMild
Contrast agent injectionDuring infusionNone
IndicationUnited States (FDA PMA): colorectal liver metastasesUnited States (FDA HDE): hepatocellular carcinoma
Table 2 Outcomes after transarterial radioembolization from recent studies (modified from Kim et al[89])
Ref.No. of patientsResponse rateSurvival (mo)Prognostic factors
Carr et al[48]65OR = 38%Okuda et al[90] I: 21 Okuda et al[90] II: 10
Salem et al[50]43PR = 47%Okuda et al[90] I: 24 Okuda et al[90] II: 13Main PVTT; AFP > 400 ng/mL tumor burden > 25%
Sangro et al[91]24PR = 24%; SD: 64%7
Young et al[80]41Okuda et al[90] I: 21.7 Okuda et al[90] II: 14.2
Kulik et al[92]71PR = 42%; SD: 35%15.5
Salem et al[63]123RR = 72%20.5Sex (female); Child-Pugh class; UNOS
Sangro et al[8]32512.8ECOG; nodules > 5; INR > 1.2; extrahepatic disease
Mazzaferro et al[56]52CR = 9.6%; OR = 40.4%15Response; Child Pugh class
Table 3 Comparison of response and median survival after transarterial radioembolization and transarterial chemoembolization from recent studies (modified from Lau et al[93])
Ref.TreatmentnOS (mo)TTP (mo)Response (CP/PR) %WHO/RECIST criteriaRR (CP/PR) %EASL criteriaDownstaged/LT %Mean days in hospitalper treatment
Lewandowski et al[69]TARE (TheraSphere1)4335.733.3618658a0a
Kooby et al[88]TARE (SIR-Spheres2)276NR11NRNR1.7a
Carr et al[68]TARE (TheraSphere1)9911.5NR41NRNRNR
Salem et al[63]TARE (TheraSphere1)12320.513.34972250a
Table 4 Response and median survival after transarterial radioembolization in hepatocellular carcinoma with or without portal vein tumour thrombosis from recent studies (modified from Okuda et al[90])
Ref.PVTTnResponse (CR/PR) %WHO/RECIST criteriaRR (CR/PR) %EASL criteriaOS
Salem et al[71]Child-Pugh A116526917.2
TheraSphere1No PVTT81537722.1
no EHSPVTT (mixed)35505010.4
Child-Pugh B12239527.7
No PVTT65476714.8
PVTT (mixed)5728325.6
Hilgard et al[55]All patients108154016.4
TheraSphere1No PVTT75NRNR16.4
30% EHSPVTT [mixed: main (12); first/second order (12); unknown (9)]3310
Sangro et al[8]All patients325NRNR12.8
SIR-Spheres2No PVTT24915.3
9% EHSPVTT [mixed: main (32); first order (44)]7610.7/9.7
Iñarrairaegui et al[94] TheraSphere1 and SIR-Spheres2PVTT [mixed: main (6); first/second order (19)]25NRNR10
Tsai et al[95]PVTT22NRNR7
TheraSphere1 and SIR-Spheres2Main124.4
13% EHSFirst order107
Woodall et al[96]No PVTT20NRNR13.9
TheraSphere1PVTT [mixed: main (10)]153.2
Kulik et al[92]All patients1084270NR
TheraSphere1No PVTT7115.4
12% EHSPVTT main124.4
First order259.9