Radioembolización Hepática con microesferas de Y-90: aspectos metodológicos y dosimétricos

Hepatic Radioembolization (RE) or selective internal radiation therapy consists in the intra-arterial hepatic administration of 90 Y-microspheres. Several processes are carried out before RE: the evaluation of the hepatic vascular anatomy, an adequate treatment planning (including treatment subrogation), the calculation of the activity to be administered, treatment administration, and finally the evaluation of 90 Y-microspheres distribution. This requires the collaboration of a multidisciplinary team that includes experts from oncology, hepatology, interventional radiology, nuclear medicine, radiopharmacy and medical physics. Recently, the number of publications that include dosimetry aspects of RE and their relationship with the treatment outcomes have increased. An adequate dosimetry evaluation is essential for the development of an individualized treatment planning that ensures patient safety and treatment efficacy of RE with acceptable toxicity. In this paper, a review of the main methodological aspects regarding the different stages of RE is carried out. Likewise, the different dosimetric models currently available are described and analyzed, including 3D-dimensional dosimetry at voxel level.