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.


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 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 BalderiDott. Davide SortinoDott. Simone Bongiovanni – Interventional Radiologist – Santa Croce e Carle  Hospital  – Cuneo