Venkatanarasimha N, Gogna A, Tong K T A, Damodharan K, Chow P K H, Lo R H G, Chandramohan S
Department of Diagnostic Radiology, Singapore.
Department of Nuclear Medicine and PET, Singapore General Hospital, Singapore.
Clin Radiol. 2017 Dec;72(12):1002-1013. doi: 10.1016/j.crad.2017.07.021. Epub 2017 Oct 9.
Transarterial radioembolisation (TARE) has gained increasing acceptance as an additional/alternative locoregional treatment option for hepatocellular carcinoma, and colorectal hepatic metastases that present beyond potentially curative options. This is a catheter-based transarterial selective internal brachytherapy that involves injection of radioactive microspheres (usually Y-90) that are delivered selectively to the liver tumours. Owing to the combined radioactive and microembolic effect, the findings at follow-up imaging are significantly different from that seen with other transarterial treatment options. Considering increasing confidence among clinicians, refinement in techniques and increasing number of ongoing trials, TARE is expected to gain further acceptance and become an important tool in the armamentarium for the treatment of liver malignancies. So it is imperative that all radiologists involved in the management of liver malignancies are well versed with TARE to facilitate appropriate discussion at multidisciplinary meetings to direct further management. In this article, we provide a comprehensive review on various aspects of radioembolisation with Y-90 for hepatocellular carcinoma including the patient selection, treatment planning, radiation dosimetry and treatment, side effects, follow-up imaging and future direction.
经动脉放射性栓塞术（TARE）作为肝细胞癌以及超出潜在治愈性选择范围的结直肠癌肝转移的一种额外/替代局部区域治疗选择，已越来越被认可。这是一种基于导管的经动脉选择性内近距离放射疗法，涉及注射放射性微球（通常为钇-90），这些微球被选择性地输送至肝脏肿瘤。由于放射性和微栓塞效应的结合，随访成像的结果与其他经动脉治疗选择所见显著不同。鉴于临床医生的信心增强、技术的改进以及正在进行的试验数量增加，TARE有望获得进一步认可，并成为治疗肝脏恶性肿瘤的重要手段。因此，所有参与肝脏恶性肿瘤管理的放射科医生都必须精通TARE，以便在多学科会议上进行适当讨论，指导进一步的管理。在本文中，我们对使用钇-90进行放射性栓塞治疗肝细胞癌的各个方面进行了全面综述，包括患者选择、治疗计划、放射剂量测定与治疗、副作用、随访成像以及未来方向。
