Satoru Morita MD, PhD, Presenter: Nothing to Disclose

Ashwani Kumar Sharma MD, Abstract Co-Author: Nothing to Disclose

Takashi Kitanosono MD, Abstract Co-Author: Nothing to Disclose

David Yoon Lee MD, Abstract Co-Author: Nothing to Disclose

David Lee Waldman MD, PhD, Abstract Co-Author: Nothing to Disclose

To review response of lobar radioembolization for hepatocellular carcinoma (HCC) in each liver division, and compare the results between tumors located in the middle zone, which is the watershed between the right and left hepatic arterial territories, and outer zone. 

Fifty HCCs in 23 patients who underwent lobar radioembolization using Yttrium-90, single lobar treatment in 17 patients and sequential each lobar treatment in 6 patients, were retrospective reviewed. Response and reduction rates in each liver division were assessed by using modified response evaluation criteria in solid tumors (mRECIST). The results were compared between tumors in the middle (caudate lobe and left medial division) (n = 13) versus outer zone (right anterior and posterior divisions and left lateral division) (n = 37). 

The overall response rate was 62.0%. The response rate of tumors in the middle zone was significantly lower than that of tumors in the outer zone (38.5% vs. 70.3%, P = 0.042). The reduction rates in each liver division are shown in the Figure. The overall reduction rate was 45.3 ± 52.4%. The reduction rate of tumors in the middle zone was significantly lower than that in the outer zone (15.3 ± 48.1% vs. 55.8 ± 50.3%, P = 0.015). There was no significant difference in the reduction rate of tumors in the middle zone between treated by single lobar treatment (n = 8) versus sequential each lobar treatment (n = 5) (13.1 ± 51.1% vs. 16.7 ± 49.6%, P = .904). 

Response of lobar radioembolization for HCCs in the watershed between the right and left hepatic arterial territories is not sufficient compared to that in the other area. 

To be aware of the difficulty of radioembolization for tumors in the watershed between the right and left hepatic arterial territories results in selecting proper treatment techniques or options. 

Morita, S, Sharma, A, Kitanosono, T, Lee, D, Waldman, D, Response of Lobar Radioembolization for Hepatocellular Carcinoma in the Watershed Between Right and Left Hepatic Arterial Territories.  Radiological Society of North America 2012 Scientific Assembly and Annual Meeting, November 25 - November 30, 2012 ,Chicago IL. http://archive.rsna.org/2012/12027062.html