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Purpose <p>To evaluate the feasibility of streamlining radioembolization using yttrium-90 resin microspheres without lung shunt fraction (LSF) assessment in patients with colorectal liver metastases (mCRC) &lt; 7&#xa0;cm.</p> Materials and methods <p>This single-center retrospective study included 32 patients with mCRC who underwent radioembolization between June 2021 and April 2025. Eligibility criteria were: primary target tumor &lt; 7&#xa0;cm, the sum of the diameters of the two largest tumors ≤ 10&#xa0;cm, treatment with resin microspheres, omission of LSF measurement, and at least one follow-up imaging study. Radiation activity was prescribed based on tumor location, liver function, and clinical setting, using both single-compartment and multi-compartment dosimetry with assumption of a LSF of 5% and tumor-to-normal (TN) ratio of 3. Post-treatment Y-90 PET/CT dosimetry was performed in 15 patients. Clinical outcomes, tumor response, and treatment-related toxicity were analyzed.</p> Results <p>Median administered radiation activity was 0.50&#xa0;GBq (IQR, 0.41–0.82). Median mean absorbed dose (mAD) to the perfused tissue was 136&#xa0;Gy, and median tumor absorbed dose (TAD) was 347&#xa0;Gy with assumption of TN ratio of 3. Post-treatment PET/CT analysis (n = 15) showed a median TAD of 432&#xa0;Gy with a median TN ratio of 3.9, and lung dose derived from Y-90 PET/CT image ranged from 0.12 to 0.61&#xa0;Gy. The best tumor responses were complete response in 12.5%, partial response in 59.4%, and stable disease in 28.1%. One- and two-year local tumor progression-free survival rates were 70.8% and 54.1%, respectively. No patient developed radiation pneumonitis.</p> Conclusion <p>Streamlining radioembolization without LSF assessment appears feasible for patients with mCRC &lt; 7&#xa0;cm.</p>

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Feasibility study of streamlining radioembolization with yttrium-90 resin microspheres without lung shunt fraction measurement for colorectal liver metastasis < 7 cm

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年4月10日

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  • Myungsu Lee,
  • Jin Chul Paeng,
  • Jong Hyuk Lee,
  • Minseok Suh,
  • Sae-Won Han,
  • Hyo-Cheol Kim

摘要

Purpose

To evaluate the feasibility of streamlining radioembolization using yttrium-90 resin microspheres without lung shunt fraction (LSF) assessment in patients with colorectal liver metastases (mCRC) < 7 cm.

Materials and methods

This single-center retrospective study included 32 patients with mCRC who underwent radioembolization between June 2021 and April 2025. Eligibility criteria were: primary target tumor < 7 cm, the sum of the diameters of the two largest tumors ≤ 10 cm, treatment with resin microspheres, omission of LSF measurement, and at least one follow-up imaging study. Radiation activity was prescribed based on tumor location, liver function, and clinical setting, using both single-compartment and multi-compartment dosimetry with assumption of a LSF of 5% and tumor-to-normal (TN) ratio of 3. Post-treatment Y-90 PET/CT dosimetry was performed in 15 patients. Clinical outcomes, tumor response, and treatment-related toxicity were analyzed.

Results

Median administered radiation activity was 0.50 GBq (IQR, 0.41–0.82). Median mean absorbed dose (mAD) to the perfused tissue was 136 Gy, and median tumor absorbed dose (TAD) was 347 Gy with assumption of TN ratio of 3. Post-treatment PET/CT analysis (n = 15) showed a median TAD of 432 Gy with a median TN ratio of 3.9, and lung dose derived from Y-90 PET/CT image ranged from 0.12 to 0.61 Gy. The best tumor responses were complete response in 12.5%, partial response in 59.4%, and stable disease in 28.1%. One- and two-year local tumor progression-free survival rates were 70.8% and 54.1%, respectively. No patient developed radiation pneumonitis.

Conclusion

Streamlining radioembolization without LSF assessment appears feasible for patients with mCRC < 7 cm.