放射性微粒的栓塞技术 选择应用的放射源（selective application of the radiation source）
► high dose @ target tissue (tumor)
protection of the surrounding healthy liver tissue
low / little exposure to adjacent organs / structures
放射性微粒肝段栓塞(Radiation Segmentectomy)【1】 最早由Riaz 等人阐述【1】，通过放射性微粒的栓塞一个或几个肝段以治疗不可切除的肝癌。该研究计算当被栓塞肝段的活性剂量，评估其活性分布以及这一新技术的安全性。对84例不可切除的肝癌病人钇90微粒栓塞显示，治疗肝段中位容积110cm³，肿瘤内剂量为1214Gy，非肿瘤内剂量为210Gy。反应率WHO标准为59%，EASL标准为81%。TTP 12.6月（9.3-18.7），生存率为26.9月（20.5-30.2）。
一侧肝段栓塞后门静脉保留时，对侧将代偿性增生肥大【4】。治疗的同侧区域发生肝纤维化，其周围结节再生性增生。
放射性肝段栓塞并发症 肝脏毒性 Seidensticker 等人【8】报告34例非肝硬化肝脏恶性肿瘤的放射微粒栓塞治疗。全肝治疗和部分肝治疗，每组17例。
 Edeline 等人【9】也报告了34例肝硬化肝癌的病人进行放射微粒栓塞。平均最大增加对侧容积42%。注射剂量和容积变化没有关系。肝容积变化甚至发生在第3个月，没有门静脉高压的Child A级病人效果较好。 Ahmadzadehfar 等人【10】报到24例不同类型肝转移癌放射性微粒栓塞。同侧容积减少＜11%，对侧增加＞34%，脾容积增加＞17%。注射剂量和容积改变无关。肝容积变化在6周开始，进行过化疗的病人结果较差。 Fernández-Ros 等人【11】报告83例病人放射性微粒栓塞的结果。
肝功能
结论
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10. Ahmadzadehfar H, Meyer C, Ezziddin S, Sabet A, Hoff-Meyer A, Muckle M, Logvinski T, Schild HH, Biersack HJ, Wilhelm K. Hepatic volume changes induced by radioembolization with 90Y resin microspheres. A single-centre study. Eur J Nucl Med Mol Imaging. 2013 Jan;40(1):80-90
11. Fernández-Ros N, Silva N, Bilbao JI, Iñarrairaegui M, Benito A, D'Avola D, Rodriguez M, Rotellar F, Pardo F, Sangro B. Partial liver volume radioembolization induces hypertrophy in the spared hemiliver and no major signs of portal hypertension. HPB (Oxford). 2013 Mar 27.
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