Selective Yttrium-90 radioembolization of both anterior and posterior right branch in a case of right lobe multicentric HCC

TARE simulation

A 57-year old man with multifocal HCC in the IV, VII ,VIII segments underwent Yttrium90 Radioembolization (Y90-RE) in attempt to downstage the tumor.

Simulation SPET

Right hepatic artery injection of 99mTc-MAA was perfomed to simulate Y90-spheres distribution.

An SPET confirmed a good concentration in the right lobe lesions with significant uptake of  gallbladder.

AV shunts fraction to the lungs confirmed that the patient could be treated with Y90-RE.

TARE

After 15 days the patient underwent radioembolization.

With a Direxion™ microcatheter a selective injection into the two branches was easily performed thanks to the good flow rates showed by the microcatheter.

PET-CT

Pet Ct Scan confirmed good results with complete uptake by  the Y90-Spheres of HCC nodules without any gallbladder wall activities.

The torquability of the Direxion™ allows the physician to reposition the microcatheter without reinserting the guidewire minimizing radiocontaminated material during the procedure.

Study and images courtesy of
Dott. Maurizio Grosso – Chief of Interventional  and Radiology department  and Interventional Radiologist- Santa Croce e Carle  Hospital  – Cuneo
Dott. Alberto Balderi – Dott. Davide Sortino – Dott. Simone Bongiovanni – Interventional Radiologist – Santa Croce e Carle  Hospital  – Cuneo
Top