News | Interventional Radiology | July 31, 2019

Hepatocellular carcinoma guidelines supported by comparative Dosisphere data, a phase II multicentric randomized dosimetry trial

International Multidisciplinary Group Publishes Recommendations for Personalized HCC Treatment With Y90 TheraSphere

July 31, 2019 — New consensus recommendations for personalized treatment for hepatocellular carcinoma (HCC) with BTG’s TheraSphere have been published by an international multidisciplinary working group1. In addition, data from the Dosisphere phase II dosimetry trial supports MAA single photon emission computed tomography (SPECT)/CT-based prospective personalized dosimetry2.

Prof. Etienne Garin, nuclear medicine physician, Cancer Centre Eugène Marquis, Rennes, France, received the gold medal at the Global Embolization Oncology Symposium Technologies (GEST) 2019 meeting for his work on the Investigator Initiated Study (IIS) Dosisphere. This study compared the efficacy of TheraSphere in 56 patients with at least one lesion > 7cm, using a personalized approach with Simplicit90Y dosimetry software versus standard dosimetry.  Higher response rates of 71 percent were seen in the personalized prospective dosimetry arm versus 36 percent with standard dosimetry. "The future for radioembolization is personalised dosimetry," said Garin, principal investigator of the study.

"The working group reached a consensus recommendation on simple, reproducible and evidence-based practice for personalized treatment of HCC patients with TheraSphere. This publication significantly advances our knowledge of dosimetry and will help to improve clinical outcomes" said Prof. Riad Salem, chief of interventional radiology, Northwestern Memorial Hospital, Chicago. The paper1 combines conclusions from the peer-reviewed literature together with expert opinion and includes curative and palliative therapy, categorized into four clinical scenarios: radiation segmentectomy, lobectomy, multifocal unilobar or bilobar disease, and HCC with macrovascular invasion. For each scenario, recommendations are provided on patient selection, treatment planning and dosimetry, treatment delivery and outcome assessment, and degree of recommendation and the strength of consensus.

Watch the VIDEO: Y90 Embolization of Liver Cancer at Henry Ford Hospital

For more information:


1.  Salem R, Padia S, Lam M et al. Eur J Nucl Med Mol Imaging. 2019 May 16. doi: 10.1007/s00259-019-04340-5. [Epub ahead of print]

2.  Garin E, Tselikas L, Guiu B et al. A multicentric randomised study demonstrating the impact of MAA based dosimetry on tumour response with Y90 loaded glass microsphere SIRT for HCC:  interim analysis of IIS Dosisphere [Poster presentation ECIO 2019 & oral presentation GEST 2019]

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