Comparison between resin and glass microspheres for Yttrium-90 radioembolization treatment of hepatocellular carcinoma

Purpose Yttrium-90 radioembolization (RE) treatment of hepatocellular carcinoma (HCC) may be performed with either resin or glass microspheres. Differences include specific activity, microsphere size and density, embolic effect, and dose calculation. We retrospectively reviewed the differences in outcome between patients treated with glass microspheres and patients treated with resin microspheres prior to availability of glass microspheres at two centers. Materials and Methods All patients with HCC treated with either resin or glass microspheres at two collaborating centers were reviewed, including patients treated with glass microspheres at one institution. Dose calculation was based on body surface area (resin) or liver weight partition model (glass). Radiographic response was measured at 3 and 6 months according to mRECIST criteria. Laboratory and clinical follow-up was performed at 2, 4, 8 and 12 weeks. Parameters of toxicity and efficacy were compared. Results Seventy patients were treated (54 M, 16 F; median age 61; 18 resin, 52 glass microspheres). Baseline laboratory, tumor, and clinical parameters were comparable between groups, with the exception of a higher ECOG-score in the glass microsphere patients (p = 0.001). Patients treated with resin microspheres received less activity (1.41 versus 3.76 GBq; p Conclusion Higher dose glass microspheres may have a subtle response and survival advantage for yttrium-90 RE of HCC.