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Tumour-to-nontumour uptake varies among patients, possibly influenced by patient-specific blood flow profiles. To examine the impact of HA blood flow rate and high microsphere dosages on microsphere distribution in normal liver parenchyma, <jats:italic>ex vivo<\/jats:italic> magnetic resonance imaging (MRI)-guided machine perfusion experiments were conducted in porcine livers.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Materials and methods<\/jats:title>\n            <jats:p>Porcine livers were subjected to oxygenated normothermic machine perfusion at three HA flow rates (0.02, 0.15, and 0.22\u2009mL\/min\/g liver tissue; <jats:italic>n<\/jats:italic>\u2009=\u20093 per condition). Five fractions of 250\u2009mg nonradioactive <jats:sup>165<\/jats:sup>Ho-loaded microspheres were administered to <jats:italic>n<\/jats:italic>\u2009=\u20099 livers, and four additional fractions of 1,000\u2009mg to <jats:italic>n<\/jats:italic>\u2009=\u20096 livers. Dynamic contrast-enhanced and Ho-sensitive T2*-weighed MR scans were acquired to extract perfusion rates, fictive dose maps, and homogeneity indices (HI).<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Results<\/jats:title>\n            <jats:p>Microsphere distribution correlated moderately with perfusion rate at low HA flow rate (<jats:italic>r<\/jats:italic>\u2009=\u20090.611), and very strongly at higher HA flow rates (<jats:italic>r<\/jats:italic>\u2009=\u20090.977 and 0.951 for 0.15 and 0.22\u2009mL\/min\/g, respectively). Homogeneity increased with increasing flow rates, with HIs ranging from 3.68\u20134.72 at low, to 2.01\u20132.66 at medium, and 1.60\u20132.36 at high HA flow rate. HI decreased with higher microsphere concentrations, though distribution patterns remained unchanged.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Conclusion<\/jats:title>\n            <jats:p>In our <jats:italic>ex vivo<\/jats:italic> model, higher HA flow rates resulted in more homogeneous microsphere distributions. The impact on tumourous tissue needs further investigation to determine whether pre-TARE HA blood flow measurements could improve microsphere distribution predictions.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Relevance statement<\/jats:title>\n            <jats:p>Mapping of the hepatic arterial blood flow rate before transarterial radioembolisation and adjusting the treatment accordingly may help to improve outcomes for patients with liver cancer.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Key Points<\/jats:title>\n            <jats:p>\n              <jats:list list-type=\"bullet\">\n                <jats:list-item>\n                  <jats:p>Parameters influencing microsphere distribution were studied in MRI-perfused healthy porcine livers.<\/jats:p>\n                <\/jats:list-item>\n                <jats:list-item>\n                  <jats:p>Higher hepatic arterial blood flow rates led to more homogeneous microsphere distributions.<\/jats:p>\n                <\/jats:list-item>\n                <jats:list-item>\n                  <jats:p>Administering large numbers of microspheres did not alter microsphere distribution patterns.<\/jats:p>\n                <\/jats:list-item>\n                <jats:list-item>\n                  <jats:p>Impact on tumour tissue should be further investigated.<\/jats:p>\n                <\/jats:list-item>\n              <\/jats:list>\n            <\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Graphical Abstract<\/jats:title>\n          <\/jats:sec>","DOI":"10.1186\/s41747-025-00609-7","type":"journal-article","created":{"date-parts":[[2025,8,6]],"date-time":"2025-08-06T16:22:17Z","timestamp":1754497337000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["The influence of hepatic arterial blood flow rate on holmium microsphere distribution: an MRI study in perfused porcine livers"],"prefix":"10.1186","volume":"9","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4403-7916","authenticated-orcid":false,"given":"Tess J.","family":"Snoeijink","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anne","family":"van den Brekel","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jan L.","family":"van der Hoek","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jaap G. 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The procurement process did not interfere with the standard abattoir protocol and was in accordance with the Dutch Food Safety Authority guidelines.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"The procurement process did not interfere with the standard abattoir protocol and was in accordance with the Dutch Food Safety Authority guidelines.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"FN is the co-founder of Quirem Medical, which was acquired by Terumo Europe NV in July 2020. Nijsen has a scientific advisory role and is entitled to certain milestone payments from Terumo, which are related to Quirem\u2019s financial, operational and regulatory performance in the future. Furthermore, Nijsen is the inventor of the patents related to radioactive microspheres that are assigned to University Medical Centre Utrecht Holding BV, Quirem Medical or BASF Corp. The activities of FN within Quirem Medical are approved and supported by the Board of Directors of the Radboudumc. The other authors declare that they have no conflict of interest.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"69"}}