Fig. 3.

64 year old male diagnosed with intrahepatic metastatic cholangiocarcinoma (ICC), with distinct lesions in segment 8, 4 and a minor lesion on the edge of segment 3/4B (A and B). At tumor board, he was considered to be eligible for radioembolization treatment with ¹⁶⁶Ho microspheres, which he received after an uneventful ¹⁶⁶Ho scout procedure. On the day of treatment a superselective injection of 1.6 GBq (radiation segmentectomy) in segment 8 (C) and segmental injection of 0.8 GBq in segment 4 (D) was executed. Post-treatment SPECT/CT showed a good accumulation of particles around the tumor in segment 8 (E) and segment 4 (F). Contrast enhanced CT (G + H) and ¹⁸FDG-PET (not shown) acquired 2 months after treatment showed a near complete regression of the segment 8 lesion and partial response of the segment 4 lesion. Recent follow-up treatment (not shown) consisted of additional ¹⁶⁶Ho radioembolization of segment 4 and superselective in segment 3. Segment 8 lesion is still in (near) complete remission