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放射性栓塞:技术要点与随访成像

Radioembolization: Technical Tips and Follow-Up Imaging.

作者信息

Kim Hyo-Cheol

出版信息

J Korean Soc Radiol. 2025 Jul;86(4):457-469. doi: 10.3348/jksr.2025.0032. Epub 2025 Jul 25.

Abstract

Transarterial radioembolization (TARE) is a minimally invasive treatment modality for hepatocellular carcinoma (HCC) that delivers targeted radiation via radioactive microspheres. The procedure entails selective catheterization of the hepatic artery, followed by infusion of yttrium-90-labeled microspheres directly into the arterial supply of the tumor. Several technical strategies are employed to optimize precise radiation delivery while minimizing exposure to surrounding healthy liver tissue. Post-procedure imaging is crucial for assessing therapeutic efficacy. Contrast-enhanced CT or MRI is routinely performed to evaluate tumor response, which may manifest as reductions in tumor size, decreased vascularity, or increased necrosis. It is important to recognize that radioembolization-induced changes in the liver parenchyma can mimic tumor recurrence, which may lead to unnecessary additional interventions if misinterpreted. Follow-up imaging also plays an essential role in identifying potential complications, including non-target radiation injury and disease progression. Overall, TARE has demonstrated promising outcomes in improving survival and quality of life for patients with HCC, establishing itself as a valuable option within the multidisciplinary management of liver cancer.

摘要

经动脉放射性栓塞术(TARE)是一种用于肝细胞癌(HCC)的微创治疗方式,它通过放射性微球传递靶向辐射。该手术需要对肝动脉进行选择性插管,然后将钇-90标记的微球直接注入肿瘤的动脉供血中。采用了几种技术策略来优化精确的辐射传递,同时尽量减少对周围健康肝组织的辐射暴露。术后成像对于评估治疗效果至关重要。常规进行对比增强CT或MRI以评估肿瘤反应,这可能表现为肿瘤大小减小、血管减少或坏死增加。必须认识到,放射性栓塞引起的肝实质变化可能会模仿肿瘤复发,如果误诊可能会导致不必要的额外干预。随访成像在识别潜在并发症(包括非靶向辐射损伤和疾病进展)方面也起着至关重要的作用。总体而言,TARE在改善HCC患者的生存率和生活质量方面已显示出有希望的结果,使其成为肝癌多学科管理中的一个有价值的选择。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d0b3/12328915/c0e02ddaafd2/jksr-86-457-g001.jpg

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