Clinical, dosimetric, and reporting considerations for Y-90 glass microspheres in hepatocellular carcinoma: updated 2022 recommendations from an international multidisciplinary working group

Purpose In light of recently published clinical reports and trials, the TheraSphere Global Dosimetry Steering Committee (DSC) reconvened to review new data and to update previously published clinical and dosimetric recommendations for the treatment of hepatocellular carcinoma (HCC). Methods The Ther...

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Bibliographic Details
Published in:European journal of nuclear medicine and molecular imaging 2023-01, Vol.50 (2), p.328-343
Main Authors: Salem, Riad, Padia, Siddharth A., Lam, Marnix, Chiesa, Carlo, Haste, Paul, Sangro, Bruno, Toskich, Beau, Fowers, Kirk, Herman, Joseph M., Kappadath, S. Cheenu, Leung, Thomas, Sze, Daniel Y., Kim, Edward, Garin, Etienne
Format: Article
Language:English
Subjects:
Carcinoma, Hepatocellular - pathology
Cardiology
Clinical trials
Delphi method
Dosimeters
Dosimetry
Embolization, Therapeutic - methods
Glass
Guidelines
Health services
Hepatocellular carcinoma
Humans
Imaging
Life Sciences
Literature reviews
Liver cancer
Liver Neoplasms - diagnostic imaging
Liver Neoplasms - drug therapy
Liver Neoplasms - radiotherapy
Medicine
Medicine & Public Health
Microspheres
Nuclear Medicine
Oncology
Orthopedics
Patients
Radiology
Radiopharmaceuticals - therapeutic use
Tumors
Yttrium
Yttrium isotopes
Yttrium Radioisotopes - therapeutic use
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Summary:Purpose In light of recently published clinical reports and trials, the TheraSphere Global Dosimetry Steering Committee (DSC) reconvened to review new data and to update previously published clinical and dosimetric recommendations for the treatment of hepatocellular carcinoma (HCC). Methods The TheraSphere Global DSC is comprised of health care providers across multiple disciplines involved in the treatment of HCC with yttrium-90 (Y-90) glass microsphere–based transarterial radioembolization (TARE). Literature published between January 2019 and September 2021 was reviewed, discussed, and adjudicated by the Delphi method. Recommendations included in this updated document incorporate both the results of the literature review and the expert opinion and experience of members of the committee. Results Committee discussion and consensus led to the expansion of recommendations to apply to five common clinical scenarios in patients with HCC to support more individualized efficacious treatment with Y-90 glass microspheres. Existing clinical scenarios were updated to reflect recent developments in dosimetry approaches and broader treatment paradigms evolving for patients presenting with HCC. Conclusion Updated consensus recommendations are provided to guide clinical and dosimetric approaches for the use of Y-90 glass microsphere TARE in HCC, accounting for disease presentation, tumor biology, and treatment intent.
ISSN:1619-7070
1619-7089
DOI:10.1007/s00259-022-05956-w