Transarterial Radioembolization for Hepatic Malignancies in North and South America

Abstract

Transarterial radioembolization (TARE) with yttrium 90 is increasingly utilized for the treatment of hepatic neoplasms, whether primary (particularly hepatocellular carcinoma [HCC]) or metastatic (particularly colorectal). Extensive data and practical experience have led to a better understanding of its most appropriate usage and optimal techniques, particularly regarding dosimetry. Different clinical contexts and technical parameters allow its use with either palliative or curative intent. Improved patient outcomes have led to its inclusion in management guidelines of HCC and colorectal cancer. While available in multiple centers in the United States and Canada, its availability in South America is still very limited. The objective of this article is to review available treatment platforms, indications, techniques, recent advances, and clinical results, as well as briefly explore the disparities in availability throughout the United States.