Streamlined Resin Y90 Radiation Segmentectomy for Small HCC

Inclusion criteria

• 18 years of age or older
• Has focal Hepatocellular Carcinoma and is deemed to benefit from Yttrium-90 radioembolization by the institutional multidisciplinary tumor board

Exclusion criteria

• All subjects meeting any of the exclusion criteria at baseline will be excluded from study participation.
• The presence of trans-jugular intrahepatic portosystemic shunt
• Total bilirubin level > 3.0 mg/dL
• Serum albumin level < 2.5 g/dL
• Aspartate and alanine aminotransferase levels no greater than five times the normal level
• Life expectancy < 12 weeks
• Eastern Cooperative Oncology Group performance status > 2
• Patients with chronic lung disease requiring supplemental oxygen at baseline or baseline SpO2 of <92%
• Patients that have tumors with central anatomical locations close the hepatic hilum or caudate lobe.
• Patients with macrovascular invasion on baseline imaging
• Known hypersensitivity to iodinated contrast agents or to any component of iodinated contrast agents refractory to standard medications (antihistamines, steroids)
• Impaired kidney function (glomerular filtration rate < 30 as approximated using serum creatinine levels) unless anuric and on dialysis.
• Any woman who is pregnant or has reason to believe she is pregnant (the possibility of pregnancy has to be excluded by negative urine β-HCG results, obtained within 48 hours prior to the treatment or on the basis of patient history, e.g.: tubal ligation, hysterectomy or a minimum of 1 year without menses)