ArticleEuropean journal of nuclear medicine and molecular imaging2026
Interventional strategies for inferior phrenic artery management in yttrium‑90 selective internal radiation therapy for hepatocellular carcinoma: A single‑center retrospective study.
Article in European journal of nuclear medicine and molecular imaging, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
objectiveExtrahepatic collateral supply from the inferior phrenic artery (IPA) is frequently observed in patients with hepatocellular carcinoma (HCC) undergoing yttrium-90 selective internal radiation therapy (
methodsA retrospective analysis was performed on 290 consecutive unresectable HCC patients treated with
resultsA total of 78 patients with angiographically confirmed IPA tumor supply were finally enrolled, including 45 patients in the IPA Y-90 infusion group and 33 in the IPA embolization group. The median administered radioactivity via IPA was 0.3 GBq. Based on modified Response Evaluation Criteria in Solid Tumors (mRECIST), the objective response rates (ORRs) at 1 and 3 months were 60.0% and 82.3% in the infusion group, versus 48.5% and 69.7% in the embolization group. The compensatory distribution rate of Y-90 microspheres in the original IPA-perfused regions reached approximately 88.0% after IPA embolization. Only mild, reversible thoracic adverse events were noted in both groups, with no severe treatment-related complications.
conclusionDSA-CBCT combined evaluation is essential for pre-procedural IPA anatomical assessment. Direct Y-90 microsphere infusion via IPA yields superior tumor control when non-target vessels are manageable and IPA-perfused tumor volume ≥ 20 mL. IPA embolization is a reliable alternative for patients with untreatable non-target branches or tumor volume < 20 mL. Both strategies demonstrate favorable safety profiles. The proposed stratified algorithm represents a preliminary approach that warrants further external validation for IPA management during
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