Session Invited Program IM- Nuclear Medicine General

New Advances in Y90 Radioembolization

Description

Interest in Y-90 dosimetry for liver radioembolization has grown rapidly as clinical evidence demonstrates a clear relationship between absorbed dose, treatment response, and toxicity. Historically, activity prescriptions were based on simplified empirical or body surface area methods, assuming uniform microsphere distribution. However, quantitative post-therapy imaging with Y-90 PET/CT and SPECT/CT has revealed substantial heterogeneity in tumor and normal-liver dose, explaining why patients receiving the same administered activity experience very different outcomes. Studies now show that higher tumor absorbed doses correlate with better response and survival, while exceeding normal-liver or lung thresholds predicts toxicity and liver failure. These findings have shifted the focus toward personalized, image-based dosimetry, where treatment is guided by the actual absorbed dose rather than the injected activity. This session will review the current clinical role of radioembolization in the management of liver tumors and examine the main challenges in implementing predictive dosimetry for treatment optimization. The session will conclude with an overview of emerging technologies and future devices in radioembolization

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