From the Department of Radiology, Northwestern Memorial Hospital, Northwestern University Feinberg School of Medicine, 676 N St. Clair St, Ste 800, Chicago, IL 60611.
Radiographics. 2021 Oct;41(6):1802-1818. doi: 10.1148/rg.2021210014. Epub 2021 Sep 24.
Transarterial radioembolization (TARE) with yttrium 90 has increasingly been performed to treat hepatocellular carcinoma (HCC). TARE was historically used as a palliative lobar therapy for patients with advanced HCC beyond surgical options, ablation, or transarterial chemoembolization, but recent advancements have led to its application across the Barcelona Clinic Liver Cancer staging paradigm. Newer techniques, termed and , are being performed before liver resection to facilitate hypertrophy of the future liver remnant, before liver transplant to bridge or downstage to transplant, or as a definite curative treatment. Imaging assessment of therapeutic response to TARE is challenging as the intent of TARE is to deliver local high-dose radiation to tumors through microembolic microspheres, preserving blood flow to promote radiation injury to the tumor. Because of the microembolic nature, early imaging assessment after TARE cannot rely solely on changes in size. Knowledge of the evolving methods of TARE along with the tools to assess posttreatment imaging and response is essential to optimize TARE as a therapeutic option for patients with HCC. RSNA, 2021.
经动脉放射性栓塞术 (TARE) 联合钇 90 已广泛用于治疗肝细胞癌 (HCC)。TARE 历史上被用作晚期 HCC 患者的姑息性叶治疗方法，这些患者已超出手术、消融或经动脉化疗栓塞等治疗选择，但最近的进展使其在巴塞罗那临床肝癌分期模式中得到应用。新技术，分别称为 和 ，在肝切除术前进行，以促进未来肝残块的肥大，在肝移植前进行桥接或降期移植，或作为确定性治愈治疗。TARE 治疗反应的影像学评估具有挑战性，因为 TARE 的目的是通过微栓塞微球向肿瘤提供局部高剂量辐射，同时保持血流以促进肿瘤的辐射损伤。由于栓塞的性质，TARE 后早期的影像学评估不能仅依赖于肿瘤大小的变化。了解 TARE 的不断发展的方法以及评估治疗后影像学和反应的工具，对于将 TARE 作为 HCC 患者的治疗选择进行优化至关重要。RSNA，2021 年。
