Combination Ipsilateral Lobar and Segmental Radioembolization Using Glass Yttrium-90 Microspheres for Treatment of Multifocal Hepatic Malignancies

Eight patients with primary (n = 6) and metastatic (n = 2) disease of the liver underwent yttrium-90 radioembolization with glass microspheres using a combination of segmental and ipsilateral lobar approach to treat multifocal tumors containing a single dominant tumor. The superselective dose was administered to the dominant tumor, whereas lobar infusion was used for smaller tumors. Assuming uniform distribution, median dose to the segment with dominant tumor was 412.3 Gy and to the remaining lobe was 117.5 Gy. No instances of radiation-induced liver disease occurred. Combined segmental and ipsilateral lobar radioembolization is a well-tolerated procedure to treat unilateral multifocal hepatic tumors including a single dominant tumor.