Radioembolization In Treatment of Hepatocellular Carcinoma with Portal Vein Invasion

Abstract

Hepatocellular carcinoma (HCC) is one of the most common cancers. Overall incidence is more than a million cases every year and it is increasing over the last decade (Laroia 2013). The diagnosis of HCC is based on either very specific CT/MRI findings or a tissue specimen (Jain, 2014). Hepatic vascularisation is complex, and anatomic variations are very frequent. Nevertheless, it is essential to be able to recognize this both in conventional imaging (planning of the procedure) and on angiography for any hepatic procedure by endovascular route. This perfect understanding helps optimize the treatment and avoids the non targeted arteries, responsible for sometimes severe complications (Favelier et al., 2014). Portal vein tumor thrombosis (PVTT) is a poor prognostic factor for HCC. PVTT is present in 10%-40% of HCC at the time of diagnosis. The optimal treatment for cases with HCC and PVTT is largely controversial. Over the past two decades, progress has been made in the management of patients with hepatocellular carcinoma (HCC) and portal vein tumor thrombosis (PVTT). Yttrium-90 ( 90 Y) radioembolization has been made a treatment option for those patients. It was reported that 90 Y radioembolization is a safe and effective treatment for patients with HCC and PVTT (Jie et al., 2016).