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Indications, Safety, and Warnings
  1. Package Insert – TheraSphere® Yttrium-90 Glass Microspheres – Rev. 14. Biocompatibles UK Ltd, a BTG International group company.
  2. Walrand S, Hesse M, Jamar F, et al. A hepatic dose-toxicity model opening the way toward individualized radioembolization planning. J Nucl Med 2014;55(8):1317–22.
  3. Hilgard P, Hamami M, Fouly AE, et al. Radioembolization with yttrium-90 glass microspheres in hepatocellular carcinoma: European experience on safety and long-term survival. Hepatology 2010;52(5):1741–9.
  4. Riaz A, Gates VL, Atassi B, et al. Radiation segmentectomy: a novel approach to increase safety and efficacy off radioembolization. Int J Radiat Oncol Biol Phys 2011;79(1):163–71.
  5. Mazzaferro V, Sposito C, Bhoori S, et al. Yttrium-90 radioembolization for intermediate-advanced hepatocellular carcinoma: a phase 2 study. Hepatology 2013;57(5):1826–37.
  6. Vouche M, Habib A, Ward TJ, et al. Unresectable solitary hepatocellular carcinoma not amenable to radiofrequency ablation: multicenter radiology-pathology correlation and survival of radiation segmentectomy. Hepatology 2014;60(1):192–201.
  7. Salem R, Lewandowski RJ, Kulik L, et al. Radioembolization results in longer time-to-progression and reduced toxicity compared with chemoembolization in patients with hepatocellular carcinoma. Gastroenterology 2011;140(2):497–507.
  8. Lewandowski RJ, Kulik LM, Riaz A, et al. A comparative analysis of transarterial downstaging for hepatocellular carcinoma: chemoembolization versus radioembolization. Am J Transplant 2009;9(8):1920–8.
  9. Kennedy A, Nag S, Salem R, et al. Recommendations for radioembolization of hepatic malignancies using yttrium-90 microsphere brachytherapy: a consensus panel report from the radioembolization brachytherapy oncology consortium. Int J Radiat Oncol Biol Phys 2007;68(1):13–23.
  10. Merkel C, Montagnese S, Amodio P. Functional Anatomy of Liver Circulation. Functional Molecular Imaging in Hepatology. Ed. Keiding S, Sorensen M, Bentham Science, 2014.
  11. Salem R, Thurston KG. Radioembolization with 90Yttrium microspheres: a state-of-the-art brachytherapy treatment for primary and secondary liver malignancies. Part 1: Technical and methodologic considerations. J Vasc Interv Radiol 2006;17:1251–78.
  12. Kulik M, Carr B, Mulcahy M, et al. Safety and efficacy of 90Y radiotherapy for hepatocellular carcinoma with and without portal vein thrombosis. Hepatology 2008;47(1):71–81.
  13. Salem R, Lewandowski RJ, Mulcahy MF, et al. Radioembolization for hepatocellular carcinoma using Yttrium-90 microspheres: a comprehensive report of long-term outcomes. Gastroenterology 2010;138(1):52–64.
  14. Llovet JM, Di Bisceglie AM, Bruix J, et al. Design and endpoints of clinical trials in hepatocellular carcinoma. J Natl Cancer Inst 2008;100(10):698–711.
  15. Reference Manual – TheraSphere® Yttrium-90 Glass Microspheres – Biocompatibles UK Ltd, a BTG International group company.
  16. BTG, Data on file. June 2, 2015.
  17. Salem R, Gilbertsen M, Butt Z, et al. Increased quality of life among hepatocellular carcinoma patients treated with radioembolization, compared with chemoembolization. Clin Gastroenterol Hepatol 2013;11(10):1358–65.
  18. Steel J, Baum A, Carr B. Quality of life in patients diagnosed with primary hepatocellular carcinoma: hepatic arterial infusion of Cisplatin versus 90-Yttrium microspheres (Therasphere). Psycho-Oncology 2004;13(2):73–9.
  19. Lambert B, Sturm E, Mertens J, et al. Intra-arterial treatment with 90Y microspheres for hepatocellular carcinoma: 4 years experience at the Ghent University Hospital. Eur J Nuc Mol Imaging 2011;38(1):2117–2124.
  20. McCann J, Larkin A, Martino L, et al. Radiation emission from patients treated with selective hepatic radioembolization using yttrium-90 microspheres: are contact restrictions necessary? J Vasc Interv Radiol 2012;23(1):661–7.
  21. GLOBOCAN website. http://globocan.iarc.fr/Pages/fact_sheets_cancer.aspx. Accessed June 29, 2015.
  22. American Cancer Society. Liver cancer. Available at www.cancer.org. Accessed June 29, 2015.
  23. Chowdhury R, Satoskar R. Chapter 2: Surveillance for Hepatocellular Carcinoma. Primary Liver Cancer Surveillance, Diagnosis and Treatment. Humana Press; 2012
  24. Kulik LM, Carr BI, Mulcahy MF, et al. Safety and efficacy of 90Y radiotherapy for hepatocellular carcinoma with and without portal vein thrombosis. Hepatology 2008;47(1):71–81.
  25. Abdel-Misih SRZ, Bloomston M. Liver Anatomy. Surgical Clinics 2010;90(4):643–53.
  26. Dancygier H. Clinical Hepatology. Springer-Verlag Berlin Heidelberg; 2010.
  27. Canadian Liver Foundation. Cirrhosis of the liver. Available at www.liver.ca. Accessed June 29, 2015.
  28. Eipel C, Abshagen K, Vollmar B. Regulation of hepatic blood flow: The hepatic arterial buffer response revisited. World J Gastroenterol 2010;16(48):6046–57.
  29. Barrett K, Brooks H, Boitano S, et al. Ganong’s Review of Medical Physiology, 23rd edition. McGraw-Hill; 2012.
  30. Canadian Cancer Society, Liver cancer. Available at www.cancer.ca. Accessed June 29, 2015.
  31. Cancer Research UK. The liver. Available at www.cancerresearchuk.org. Accessed June 29, 2015.
  32. National Library of Medicine. How does the liver work. Available at www.ncbi.nlm.nih.gov/pubmedhealth/PMH0072577. Accessed June 29, 2015.
  33. Cancer Research UK. Risks and causes of liver cancer. Available at www.cancerresearchuk.org. Accessed June 29, 2015.
  34. American Cancer Society. What are the risk factors for liver cancer? Available at www.cancer.org. Accessed June 29, 2015.
  35. Wei SJ. All about liver cancer. Available at www.oncolink.org. Accessed June 29, 2015.
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  39. Garin E, Rolland Y, Pracht M, et al. High impact of macroaggegated albumin-based tumour does on response and overall survival in hepatocellular carcinoma patients treated with 90Y-loaded glass microsphere radioembolization. Liver Int 2017;37(1):101–10.
  40. Garin E, Lenoir L, Rolland Y, et al. Dosimetry based on 99mTc-macroaggregated albumin SPECT/CT accurately predicts tumor response and survival in hepatocellular carcinoma patients treated with 90Y-loaded glass microspheres: preliminary results. J Nucl Med 2012;53(2):255–63.
  41. Laffont S, Rolland Y, Ardisson V, et al. Occupational radiation exposure for medical staff performing 90Y-loaded microsphere radioembolization. Eur J Nucl Med Mol Imaging 2016;43(5):824–31.
  42. Garin E, Laffont S, Rolland Y, et al. Safe radiation exposure of medical personnel using simple radioprotection means while administering 131I-lipiodol therapy for hepatocellular carcinoma. Nucl Med Comm 2003;24:671–8.
  43. Mauxion T, Fischer A, Dreher M, et al. Dosimetric analysis of 90Y glass and resin microsphere distributions in hepatic tumors: From the microsphere coverage to the absorbed dose. J Vasc Interv Radiol 2016;27:S61.
  44. NCCN Guidelines: Hepatobiliary Cancers Version 2.2016.
  45. Atassi B, Bangash AK, Bahrani A, et al. Multimodality imaging following 90Y radioembolization: a comprehensive review and pictorial essay. Radiographics 2008;28(1):81–99.
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