Safety and Efficacy of Y-90 Radioembolization After Prior Major Hepatic Resection: Dosimetric Consideration

Excerpt

With great interest, we read the article by Zimmermann et al., addressing the safety of radioembolization with yttrium-90 resin microspheres (⁹⁰Y RE) in patients with a history of major hepatic resection [1]. In all patients, the body surface area (BSA) method was used for activity calculation. The authors concluded that ⁹⁰Y RE was safe in patients with a history of major liver resection (including extended hemihepatectomy) while using the BSA method for activity calculation. This study addresses a clinically important issue that needs attention. There are no guidelines on activity adjustments in patients with a heavily pretreated liver (either surgery or systemic treatment). Clinical studies investigating this issue are clearly needed. However, the results of the presented study should be evaluated critically, before assumptions become guidelines. …