MRI-guided Holmium-166 Radioembolization

Launched by RADBOUD UNIVERSITY MEDICAL CENTER · Nov 1, 2022

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Eligibility criteria

• Inclusion Criteria:
• • 1. Diagnosis of hepatocellular carcinoma BCLC stage B or C
• • 2. At least one lesion of 10 mm or more in the longest diameter on contrast-enhanced MRI/CT
• • 3. Patient is eligible for TARE as determined by the tumour board (in Dutch: MDO)
• • 4. Patient has a life expectancy of 12 weeks or longer
• • 5. Patient has a WHO performance score of 0-2
• Exclusion Criteria:
• • 1. Extrahepatic disease that cannot be targeted during the TARE session (enlarged lymph nodes in the liver hilus are allowed)
• • 2. Radiation therapy, chemotherapy or major surgery within 4 weeks before treatment
• • 3. Serum bilirubin \> 2.0 x the upper limit of normal
• • 4. ALAT, ASAT, alkaline phosphatase (AF) \> 5x the upper limit of normal
• • 5. Leukocytes \<4.0 \* 109/L or platelet count \<60 \* 109/L
• • 6. Significant heart disease that in the opinion of the physician increases the risk of ventricular arrhythmia.
• • 7. Pregnancy or breast feeding
• • 8. Disease with increased chance of liver toxicity, such as primary biliary cirrhosis or xeroderma pigmentosum
• • 9. Patients ineligible to undergo MR-imaging (claustrophobia, metal implants, etc)
• • 10. Portal vein thrombosis of the main branch (more distal branches are allowed)
• • 11. Untreated, active hepatitis
• • 12. Body weight \> 150 kg (because of maximum table load)
• • 13. Severe allergy for i.v. contrast (Iomeron, Dotarem and/or Primovist)
• • 14. Lung shunt \> 30 Gy, as calculated using scout dose 166Ho SPECT/CT.
• • 15. Uncorrectable extrahepatic deposition of scout dose activity. Activity in the falciform ligament, portal lymph nodes or gallbladder are accepted.
• • 16. Unstable final catheter position due to hepatic artery anatomy, which might lead to dislocation of the catheter during transfer to the MRI.