Evidence map›Paper›PMID 40289050›Full record

ArticleEJNMMI research2025

Spatial distribution of fractionally administered holmium microspheres in non-tumorous human liver tissue: how livers survive transarterial radioembolisation.

Anne van den Brekel, Tess J Snoeijink, Vincent E de Meijer, Milou Boswinkel, Koert P de Jong, Joey Roosen, Alexandra G Arranja, Jurgen J Fütterer, Simeon J S Ruiter, J Frank W Nijsen

Registry-linked trialAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in EJNMMI research, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT04269499 (Real-time MR Imaged Treatment With Holmium Microspheres of Patients With Primary or Secondary Liver Cancer; a Feasibility Study), which is not on this map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT04269499 nacompletednot on this map

Real-time MR Imaged Treatment With Holmium Microspheres of Patients With Primary or Secondary Liver Cancer; a Feasibility Study

TypeinterventionalSponsorRadboud University Medical CenterRan2019 to 2021Enrolled6ConditionsLiver Cancer, Liver MetastasesArmsQuiremSpheres®
3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors.

Anne van den BrekelMinimally Invasive Image-Guided Intervention Center (MAGIC), Department of Medical Imaging, Radboud University Medical Center, Nijmegen, The Netherlands. Anne.vandenBrekel@radboudumc.nl.ORCID http://orcid.org/0000-0002-7875-9135
Tess J SnoeijinkMinimally Invasive Image-Guided Intervention Center (MAGIC), Department of Medical Imaging, Radboud University Medical Center, Nijmegen, The Netherlands.ORCID http://orcid.org/0000-0003-4403-7916
Vincent E de MeijerUMCG Comprehensive Transplant Center, Department of Hepato-Pancreato-Biliary Surgery and Liver Transplantation, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands.ORCID http://orcid.org/0000-0002-7900-5917
Milou BoswinkelNuclear Medicine (NucMed), Department of Medical Imaging, Radboud University Medical Center, Nijmegen, The Netherlands.ORCID http://orcid.org/0009-0003-5951-1008
Koert P de JongUMCG Comprehensive Transplant Center, Department of Hepato-Pancreato-Biliary Surgery and Liver Transplantation, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands.ORCID http://orcid.org/0000-0001-6345-653X
Joey RoosenMinimally Invasive Image-Guided Intervention Center (MAGIC), Department of Medical Imaging, Radboud University Medical Center, Nijmegen, The Netherlands.ORCID http://orcid.org/0000-0002-7965-6664
Alexandra G ArranjaTerumo Blood and Cell Technologies, Rua General Firmino Miguel 3, 1600-100, Lisbon, Portugal.ORCID http://orcid.org/0000-0002-5613-6084
Jurgen J FüttererMinimally Invasive Image-Guided Intervention Center (MAGIC), Department of Medical Imaging, Radboud University Medical Center, Nijmegen, The Netherlands.ORCID http://orcid.org/0000-0001-6800-2879
Simeon J S RuiterUMCG Comprehensive Transplant Center, Department of Hepato-Pancreato-Biliary Surgery and Liver Transplantation, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands.ORCID http://orcid.org/0000-0002-2298-689X
J Frank W NijsenMinimally Invasive Image-Guided Intervention Center (MAGIC), Department of Medical Imaging, Radboud University Medical Center, Nijmegen, The Netherlands.ORCID http://orcid.org/0000-0001-7625-2253

Funding

Nederlandse Organisatie voor Wetenschappelijk Onderzoek 18427
6 · The paper itself

Abstract

backgroundRelatively high mean absorbed doses to the non-tumorous liver tissue (NTLT) are generally well tolerated in transarterial radioembolisation (TARE), potentially due to a heterogeneous dose distribution. This study investigates the macroscopic and microscopic distribution of fractionally administered TARE holmium microspheres in NTLT using an experimental setup of ex vivo perfused human donor livers under magnetic resonance imaging (MRI), and validates these findings through a comparison with MRI data from TARE-treated patients.

resultsMRI-based dose maps of the TARE-treated ex vivo livers and patients revealed a heterogeneous dose distribution pattern throughout the NTLT (heterogeneity index (HI) range 2.96-10.11). Microscopic analysis confirmed this, as a wide variation in the percentage of tissue within 2.1 mm of microspheres (5.4%-84.3%) was observed. Microspheres administered in consecutive fractions decreased the heterogeneity, which was observed macroscopically by a decreased HI, and microscopically by the formation of new microsphere clusters. However, this HI decrease appeared finite, and new clusters formed near existing clusters, maintaining the overall distribution pattern.

conclusionsTARE induces a heterogeneous dose distribution pattern in human NTLT. This heterogeneous dose distribution pattern persists across additional microsphere fractions, leaving parts of the NTLT unexposed to lethal doses of ionising radiation. Combined with the regenerative capacity of the liver, this may explain why relatively high mean absorbed doses to the NTLT are generally well tolerated in TARE. REGISTRATION: For validation purposes, clinical data from patients who participated in a previous study (ClinicalTrials.gov, identifier NCT04269499, registered on February 13, 2020) was analysed in the current study.

Indexed as

Dose distributionHeterogeneityHolmiumMicrosphere distributionRadioembolisationSIRTTAREUniformity

Identifiers

PMID40289050
PMCPMC12034608

What OpenQuestion holds

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Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.