Overview
Short-acting coloration for normal liver protection in liver cancer patients undergoing radioembolization therapy a study on the effectiveness of all substances
Description
Patients' liver function can be preserved when delivery of radioembolic agents to the non-tumorous liver is minimized. This is a single-center, single-arm clinical trial to evaluate the efficacy of short-acting embolization particles to temporarily embolize the hepatic arteries toward the non-tumorous liver in patients with hepatocellular carcinoma treated by radioembolization of a large perfused volume. A transient embolic effect will be evaluated by digital subtraction angiography during the procedure. Absorbed doses of the transiently protected non-tumorous liver and unprotected non-tumorous liver will be compared by pre-treatment SPECT-CT (99mTc injection without transient embolization) and post-treatment PET-CT (Y90 injection with transient embolization). In addition, liver volume and function changes for six months will be estimated using gadoxetic acid-enhanced dynamic MRI.
Eligibility
Inclusion Criteria:
- Age > 18-year-old
- Histologically or radiologically (LI-RADS 4 or 5) diagnosed as hepatocellular carcinoma
- Patients for whom radioembolization was determined as the optimal treatment after hepatologists', hepatic surgeons' or multidisciplinary clinics.
- Patients who have not undergone local treatments such as ablation or chemoembolization in the same lobe of the liver within the past year.
- Child-Pugh class A
- Eastern Cooperative Oncology Group performance status 0-2
- Planned perfused area including two or more Couinaud segments based on angiography
- Non-tumorous liver volume / total perfused area > 50%
Exclusion Criteria:
- Hepatocellular carcinoma with vascular invasion on diagnostic imaging
- History of active cancer other than hepatocellular carcinoma within recent two years
- Surgical anastomosis of the bile duct and bowel
- Lung shunt fraction ≥ 15% on 99mTc- macroaggregated albumin lung scan
- Patients contraindicated to gelatin