Defining the Ablative Dose for Y-90 TARE

Summary

This study is being done to help doctors improve how they treat liver tumors that cannot be removed by surgery or treated with standard ablation techniques. The researchers want to find out the best amount of radiation that needs to be delivered to completely destroy (or ablate) parts of the liver that have cancer.

Eligibility

Inclusion Criteria:

* Diagnosis of hepatocellular carcinoma (HCC), cholangiocarcinoma, or liver-dominant metastatic disease not amenable to surgical resection or ablation.
* Age ≥18 years.
* Child-Pugh class A or B liver function
* Eastern Cooperative Oncology Group (ECOG) performance status of 0-2.
* Adequate organ and bone marrow function as defined below:
* Leukocytes (WBC) ≥ 3,000/mcL
* Absolute neutrophil count (ANC) ≥ 1,500/mcL
* Hemoglobin ≥ 9 g/dL
* Platelets ≥ 50,000/mcL
* Total bilirubin ≤ 3.0 mg/dL
* AST ≤ 100 U/L, ALT ≤ 120 U/L
* Creatinine ≤ 2.0 mg/dL or estimated GFR ≥ 40 mL/min/1.73 m²
* Ability to undergo imaging and laboratory evaluations required by the study.
* Ability to understand and willingness to sign a written informed consent document.

Exclusion Criteria:

* Extrahepatic metastases.
* Pregnant or breastfeeding individuals.
* Tumors requiring treatment of more than two Couinaud segments.
* Known hypersensitivity to gadolinium-based contrast agents.
* Contraindications to MRI (e.g., incompatible pacemakers, claustrophobia unresponsive to sedation).
* Coagulopathy or clinical instability precluding angiographic intervention.
* Prisoners or individuals under legal custody.
* Adults unable to consent.
* Individuals under 18 years of age.

Conditions4

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