{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,29]],"date-time":"2026-10-29T21:06:16Z","timestamp":1793307976131,"version":"4.5.0"},"reference-count":21,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2025,7,26]],"date-time":"2025-07-26T00:00:00Z","timestamp":1753488000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2025,7,26]],"date-time":"2025-07-26T00:00:00Z","timestamp":1753488000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"DOI":"10.13039\/501100003725","name":"National Research Foundation of Korea","doi-asserted-by":"crossref","award":["NRF-2023R1A2C1006509"],"award-info":[{"award-number":["NRF-2023R1A2C1006509"]}],"id":[{"id":"10.13039\/501100003725","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Eur Radiol"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>To evaluate the outcomes of yttrium-90 radioembolization (glass microspheres) in patients with unilobar hepatocellular carcinoma (HCC) and portal vein invasion (PVI) who have preserved liver function.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Materials and methods<\/jats:title>\n                    <jats:p>\n                      This study included 48 patients with unilobar HCC and PVI, all with Child-Pugh A, treated with radioembolization at a single institution between January 2016 and December 2023. Tumor response was assessed using the modified Response Evaluation Criteria in Solid Tumors (mRECIST) and localized mRECIST. Overall survival (OS) and prognostic factors were evaluated using time-to-event analyses. The mean tumor absorbed dose (TAD) threshold for achieving complete response (CR) by localized mRECIST was determined using receiver operating characteristic analysis, while the threshold associated with significantly longer OS was identified using the minimum\n                      <jats:italic>p<\/jats:italic>\n                      -value approach.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Objective response rates were 83% (40\/48) by mRECIST and 88% (42\/48) by localized mRECIST. The median OS was 47.2 months (95% CI, 19.1\u201352.1 months). The TAD was the only significant predictor of OS (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.032, hazard ratio = 0.862 per 100\u2009Gy, 95% CI\u2009=\u20090.753\u20130.988). A mean TAD\u2009&gt;\u2009574\u2009Gy provided 50% sensitivity and 86% specificity for predicting CR by localized mRECIST, while a threshold of 586\u2009Gy was proposed to significantly extend OS (median OS, 49.5 months for &gt; 586\u2009Gy and 21.9 months for \u2264 586\u2009Gy;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.021).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Radioembolization is effective for HCC with localized PVI in patients with preserved liver function, and a mean TAD\u2009&gt;\u2009600\u2009Gy is proposed to achieve improved oncologic outcomes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Key Points<\/jats:title>\n                    <jats:p>\n                      <jats:bold>\n                        <jats:italic>Question<\/jats:italic>\n                      <\/jats:bold>\n                      <jats:italic>What is the optimal radioembolization approach and its outcome for hepatocellular carcinoma with localized portal vein invasion (Vp1\u20133) in patients with preserved liver function?<\/jats:italic>\n                    <\/jats:p>\n                    <jats:p>\n                      <jats:bold>\n                        <jats:italic>Findings<\/jats:italic>\n                      <\/jats:bold>\n                      <jats:italic>A tumor absorbed dose exceeding 600\u2009Gy via a tandem approach achieved complete response rates above 80% and median overall survival longer than 49.5 months.<\/jats:italic>\n                    <\/jats:p>\n                    <jats:p>\n                      <jats:bold>\n                        <jats:italic>Clinical relevance<\/jats:italic>\n                      <\/jats:bold>\n                      <jats:italic>Ablative radioembolization, delivering a tumor absorbed dose exceeding 600\u2009Gy via a tandem approach, should be considered for hepatocellular carcinoma with localized portal vein tumor thrombosis (Vp1\u20133) in patients with preserved liver function and no extrahepatic spread.<\/jats:italic>\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Graphical Abstract<\/jats:title>\n                  <\/jats:sec>","DOI":"10.1007\/s00330-025-11882-w","type":"journal-article","created":{"date-parts":[[2025,7,26]],"date-time":"2025-07-26T14:36:38Z","timestamp":1753540598000},"page":"743-753","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":10,"title":["Yttrium-90 glass microsphere radioembolization as frontline treatment for hepatocellular carcinoma with localized portal vein invasion"],"prefix":"10.1007","volume":"36","author":[{"given":"Jin Woo","family":"Choi","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Minseok","family":"Suh","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yunhee","family":"Choi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Myungsu","family":"Lee","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jin Chul","family":"Paeng","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6016-247X","authenticated-orcid":false,"given":"Hyo-Cheol","family":"Kim","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2025,7,26]]},"reference":[{"key":"11882_CR1","doi-asserted-by":"publisher","first-page":"681","DOI":"10.1016\/j.jhep.2021.11.018","volume":"76","author":"M Reig","year":"2022","unstructured":"Reig M, Forner A, Rimola J et al (2022) BCLC strategy for prognosis prediction and treatment recommendation: the 2022 update. 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He has also received research funding from Boston Scientific, Guerbet, and Nextbiomedical, as well as travel support from SIRTEX and Nextbiomedical. H.C.K. has received honoraria from Boston Scientific, SIRTEX, and Guerbet, along with research funds and travel support from SIRTEX. M.S., Y.C., M.L., and J.C.P. have no relevant financial or non-financial interests to disclose.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflict of interest"}},{"value":"Y.C. kindly provided statistical advice for this manuscript.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Statistics and biometry"}},{"value":"Written informed consent was waived by the Institutional Review Board.","order":5,"name":"Ethics","group":{"name":"EthicsHeading","label":"Informed consent"}},{"value":"This study was approved by the Institutional Review Board of Seoul National University Hospital (approval No. 2207-139-1342).","order":6,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethical approval"}},{"value":"Not applicable.","order":7,"name":"Ethics","group":{"name":"EthicsHeading","label":"Study subjects or cohorts overlap"}},{"order":8,"name":"Ethics","group":{"name":"EthicsHeading","label":"Methodology"}}]}}