Unravelling the distribution of holmium microspheres following transarterial radioembolisation

Anne van den Brekel
Promotor J.F.W. Nijsen and J.J. Fütterer
Copromotor S.J.S. Ruiter and J. Roosen
Institute Radboud University, Nijmegen, The Netherlands
Date March 31, 2026

Transarterial radioembolisation is a treatment for liver cancer that delivers radioactive microspheres into the liver via a blood vessel. These microspheres spread unevenly: some areas in the liver receive high radiation dose, others very little. In liver tumours, this uneven distribution may reduce treatment effectiveness. Administering more microspheres makes the distribution slightly more uniform, but not completely. A higher blood flow rate results in a more uniform distribution, while a lower blood flow rate makes the distribution more uneven. A special MRI technique can measure the blood flow rate, but further research is needed before this method can be used routinely. Since an uneven distribution may affect treatment success, high-resolution imaging during the procedure seems valuable. This could help achieve a high and evenly distributed radiation dose in the tumour, and thereby possibly a better treatment outcome.

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