Fig. 4.
Transarterial radioembolization for hepatocellular carcinoma with yttrium-90-labeled microspheres. (a) Enhanced CT at the portal venous phase, performed in order to evaluate the effectiveness of a transarterial chemoembolization for a hepatocellular carcinoma. The primitive tumor shows an incomplete lipiodol uptake (arrowhead) and a portal vein tumor thrombosis (arrow). (b) Selective opacification of the artery feeding the segment IV of the liver, as 1st step of the radioembolization, consisting of the injection of a low dose of 99mTc-labeled macroaggregated albumin. (c) Immediately after the infusion of the 99mTc-labeled macroaggregated albumin, a single-photon emission computed tomography is performed, which also allows to plan the therapeutic dose of 90Y after checking the lack of pulmonary and gastro-intestinal shunting.