Purpose

To assess morphologic liver changes in hepatocellular carcinoma (HCC) patients treated with Y90-radioembolization using a quantitative volumetric approach and to investigate factors influencing those changes.

Material and methods

Ongoing retrospective study of a prospectively collected database. 37 HCC patients who underwent MRI before and 3, 6 and 12 months after Y90-radioembolization were included.

A segmentation-based three-dimensional quantification of individual liver segments, whole liver, tumor burden and spleen volumes was performed in each patient. Clinical, laboratory and imaging data, and Y90-radioembolization characteristics were analysed.

Results

Y90-radioembolization was performed for whole liver in 2 patients, right/left liver in 14/2 patients, right/left lobe in 2/4 patients, and other (sub/segmental/sectorial) for 13 patients. Untreated liver and spleen volumes increased of 9.3% & 12.6, 11.3% & 8.3% and 22% & 12.3% at 3, 6 and 12 months, respectively, compared to baseline (all, p<0.05). Untreated liver volume increase was maximal at 3 months, whereas decrease in treated liver volume was still observed at 12 months (-44%, p<0.05). Magnitude of volume increase correlated with treated liver volume and administered Y-90 activity (r=0.544;p=0.001 and r=0.411;p=0.014).

Conclusion

Dynamic changes of liver and spleen volumes were observed after Y90-radioembolization in HCC patients. The magnitude of volume increase correlated with the percentage of liver volume treated and administered Y90-activity.