. 2022 Jun 21;45(11):1634–1645. doi: 10.1007/s00270-022-03187-y

Table 3.

Recommendations and contraindications for radioembolization

Indications	Contraindications
1. Unresectable primary or metastatic hepatic disease with liver-only or liver dominant tumor burden 2. Life expectancy > 3 months 3. An eastern cooperative oncology group (ECOG) status ≤ 2 4. In case of (suspected) cirrhosis; Child–Pugh score ≤ B7 5. Preoperative radioembolization for: (a) Downstaging (b) Bridge to transplant (c) Hypertrophy induction	1. Pretreatment scan demonstrating (a) The potential of > 30 Gy radiation exposure to the lung^a (b) Flow to the gastrointestinal tract that cannot be corrected by catheter techniques 2. Limited hepatic reserve (a) Irreversibly elevated bilirubin levels (> 2.0 mg/dl) (b) Reduced albumin (< 3 g/dl) 3. Prior external beam radiation therapy involving the liver in the treatment field of view. Systemic radionuclide treatments are allowed (e.g., ¹⁷⁷Lu-dotatate) 4. Severe contrast allergy, not manageable or responsive to prophylaxis

Indications

Contraindications

1. Unresectable primary or metastatic hepatic disease with liver-only or liver dominant tumor burden

2. Life expectancy > 3 months

3. An eastern cooperative oncology group (ECOG) status ≤ 2

4. In case of (suspected) cirrhosis; Child–Pugh score ≤ B7

5. Preoperative radioembolization for:

(a) Downstaging

(b) Bridge to transplant

1. Pretreatment scan demonstrating

(a) The potential of > 30 Gy radiation exposure to the lung^a

(b) Flow to the gastrointestinal tract that cannot be corrected by catheter techniques

2. Limited hepatic reserve

(a) Irreversibly elevated bilirubin levels (> 2.0 mg/dl)

(b) Reduced albumin (< 3 g/dl)

3. Prior external beam radiation therapy involving the liver in the treatment field of view. Systemic radionuclide treatments are allowed (e.g., ¹⁷⁷Lu-dotatate)

4. Severe contrast allergy, not manageable or responsive to prophylaxis

^aBased on manufacturer’s instruction for use