Radiation segmentectomy for early hepatocellular carcinoma is curative

Affiliations

¹ Department of Radiology, Northwestern Memorial Hospital, 676 N St. Clair St, Suite 800, Chicago, IL 60611, USA. Electronic address: rsalem1@nm.org.
² Division of Interventional Radiology, Department of Radiology, David Geffen School of Medicine at University of California, Los Angeles, 757 Westwood Plaza, Room 2125, Los Angeles, CA 90095, USA.
³ Department of Radiology, Mayo Clinic, 4500 San Pablo Road, Jacksonville, FL 32224, USA.
⁴ Independent Researcher, 3340 Rexford Pl, Salt Lake City, UT, USA.
⁵ Boston Scientific, One SciMed Place, Maple Grove, MN 55311, USA.
⁶ Department of Radiology, University of Florida, 1600 SW Archer Road, Gainesville, FL 32610, USA.
⁷ Section of Interventional Radiology, Department of Medicine, University of Washington, Seattle, WA, USA.
⁸ Department of Medicine, Division of Hepatology, Northwestern Memorial Hospital, Robert H. Lurie Comprehensive Cancer Center, Chicago, IL, USA.
⁹ Department of Transplantation, Mayo Clinic, 4500 San Pablo Road, Jacksonville, FL 32224, USA.
¹⁰ Department of Radiology, Section of Interventional Radiology, Northwestern Memorial Hospital, Robert H. Lurie Comprehensive Cancer Center, 676 N St. Clair St, Suite 800, Chicago. IL 60611, USA.
¹¹ Department of Interventional Radiology. Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Place, Box 1234, New York, NY 10029, USA.

PMID: 39855352
DOI: 10.1016/j.jhep.2025.01.005

Review

Radiation segmentectomy for early hepatocellular carcinoma is curative

Riad Salem et al. J Hepatol. 2025 Jun.

. 2025 Jun;82(6):1125-1132.

doi: 10.1016/j.jhep.2025.01.005. Epub 2025 Jan 22.

Authors

Affiliations

¹ Department of Radiology, Northwestern Memorial Hospital, 676 N St. Clair St, Suite 800, Chicago, IL 60611, USA. Electronic address: rsalem1@nm.org.
² Division of Interventional Radiology, Department of Radiology, David Geffen School of Medicine at University of California, Los Angeles, 757 Westwood Plaza, Room 2125, Los Angeles, CA 90095, USA.
³ Department of Radiology, Mayo Clinic, 4500 San Pablo Road, Jacksonville, FL 32224, USA.
⁴ Independent Researcher, 3340 Rexford Pl, Salt Lake City, UT, USA.
⁵ Boston Scientific, One SciMed Place, Maple Grove, MN 55311, USA.
⁶ Department of Radiology, University of Florida, 1600 SW Archer Road, Gainesville, FL 32610, USA.
⁷ Section of Interventional Radiology, Department of Medicine, University of Washington, Seattle, WA, USA.
⁸ Department of Medicine, Division of Hepatology, Northwestern Memorial Hospital, Robert H. Lurie Comprehensive Cancer Center, Chicago, IL, USA.
⁹ Department of Transplantation, Mayo Clinic, 4500 San Pablo Road, Jacksonville, FL 32224, USA.
¹⁰ Department of Radiology, Section of Interventional Radiology, Northwestern Memorial Hospital, Robert H. Lurie Comprehensive Cancer Center, 676 N St. Clair St, Suite 800, Chicago. IL 60611, USA.
¹¹ Department of Interventional Radiology. Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Place, Box 1234, New York, NY 10029, USA.

PMID: 39855352
DOI: 10.1016/j.jhep.2025.01.005

Abstract

In this expert opinion, we provide the rationale for concluding that radiation segmentectomy (using the RADSEG method) - a technique involving the transarterial delivery of an ablative, complete necrosis-inducing dose of yttrium-90 radiotherapy - is curative in limited-disease burden hepatocellular carcinoma (HCC). Currently, curative options for early stage and other carefully selected HCC cases include transplantation, resection, and ablation. Because of issues with organ availability, co-morbidities preventing resection, and tumour size and location limiting ablation, other treatments are necessary for this selected patient population. The RADSEG method has evolved into an intra-arterial approach in this setting, with long-term outcomes comparable to ablation, resection, and transplantation. It is proposed that yttrium-90 radioembolisation, applying the RADSEG technique, be formally recognised as curative for early HCC.

Keywords: Carcinoma; Hepatocellular; RADSEG treatment; Radiotherapy; TARE; Yttrium-90.

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Conflict of interest statement

Conflict of interest Dr Salem reports consulting fees from Boston Scientific, Siemens, Cook, Becton-Dickinson, Genentech, Astrazeneca, Eisai and Sirtex. Dr. Padia reports personal fees from Boston Scientific, outside the submitted work. Dr. Toskich is an advisor to Boston Scientific and Johnson and Johnson. Dr. Callahan was a paid technical consultant for BTG for his contribution to this publication. Dr. Fowers is an employee of Boston Scientific, during the conduct of the study; other from Boston Scientific, outside the submitted work. Dr. Geller reports personal fees from BTG/Boston Scientific, outside the submitted work. Dr Johnson is an advisor to Boston Scientific. Dr Kulik is an advisor to Eisai and Boston Scientific. Dr. Patel has nothing to disclose. Dr. Lewandowski reports personal fees from Boston Scientific, outside the submitted work. Dr Kim is an advisor to Boston Scientific, outside the submitted work. Please refer to the accompanying ICMJE disclosure forms for further details.

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Radiation segmentectomy for early hepatocellular carcinoma is curative

Affiliations

Radiation segmentectomy for early hepatocellular carcinoma is curative

Authors

Affiliations

Abstract

Conflict of interest statement

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Medical