{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,23]],"date-time":"2026-10-23T21:01:05Z","timestamp":1792789265723,"version":"4.5.0"},"reference-count":32,"publisher":"MDPI AG","issue":"19","license":[{"start":{"date-parts":[[2026,9,27]],"date-time":"2026-09-27T00:00:00Z","timestamp":1790467200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"European Union","award":["101112053"],"award-info":[{"award-number":["101112053"]}],"id":[{"id":"https:\/\/ror.org\/019w4f821","id-type":"ROR","asserted-by":"crossref"}]},{"award":["101112053"],"award-info":[{"award-number":["101112053"]}],"id":[{"id":"https:\/\/ror.org\/019w4f821","id-type":"ROR","asserted-by":"publisher"}]},{"name":"life science industries represented by COCIR, EFPIA\/Vaccines Europe, EuropaBio and MedTech Europe"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Cancers"],"abstract":"<jats:p>Purpose: The effectiveness of transarterial radioembolization (TARE) depends largely on the tumor-to-non-tumor ratio (TNR): the ratio of microsphere concentration between tumor and non-tumorous liver tissue. Angiotensin II (AT-II) may improve TNR by inducing vasoconstriction primarily in arteries supplying healthy liver parenchyma. Tumor-feeding arteries, lacking neurovascular innervation, are largely unresponsive to AT-II, potentially resulting in preferential blood flow redistribution toward tumor tissue. The RADIANT study aims to evaluate whether intra-arterial AT-II infusion prior to yttrium-90 (90Y) microsphere injection improves tumor selectivity during TARE in patients with primary or metastatic liver tumors. Materials and Methods: This single-center, single-arm phase II study will include 15 patients with primary or metastatic liver tumors (any histological subtype, diameter \u2265 2 cm) referred for 90Y glass radioembolization. Each patient serves as their own control: during work-up, technetium-99m macroaggregated albumin (99mTc-MAA) is administered without AT-II and TNR is measured on SPECT\/CT. During the therapeutic procedure, AT-II is infused intra-arterially (10 \u00b5g\/min over 100 s) immediately before 90Y microsphere injection, and TNR is measured on post-treatment 90Y PET\/CT. The primary endpoint is the TNR improvement factor (TNR after 90Y + AT-II divided by TNR after 99mTc-MAA). Secondary endpoints include toxicity and technical success of AT-II administration. Discussion: The RADIANT study will provide prospective evidence on the effect of intra-arterial AT-II infusion on tumor selectivity during 90Y radioembolization.<\/jats:p>","DOI":"10.3390\/cancers18193129","type":"journal-article","created":{"date-parts":[[2026,9,28]],"date-time":"2026-09-28T10:00:34Z","timestamp":1790589634000},"page":"3129","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Radioembolization with Intra-Arterial Angiotensin II to Improve Tumor-Absorbed Dose (RADIANT): A Single-Arm Phase II Study Protocol"],"prefix":"10.3390","volume":"18","author":[{"given":"Niek","family":"Wijnen","sequence":"first","affiliation":[{"name":"Department of Radiology and Nuclear Medicine, University Medical Center Utrecht, 3584 CX Utrecht, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marnix G. E. H.","family":"Lam","sequence":"additional","affiliation":[{"name":"Department of Radiology and Nuclear Medicine, University Medical Center Utrecht, 3584 CX Utrecht, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4600-4301","authenticated-orcid":false,"given":"Khalil","family":"Ramdhani","sequence":"additional","affiliation":[{"name":"Department of Radiology and Nuclear Medicine, University Medical Center Utrecht, 3584 CX Utrecht, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5167-4027","authenticated-orcid":false,"given":"Rutger C. G.","family":"Bruijnen","sequence":"additional","affiliation":[{"name":"Department of Radiology and Nuclear Medicine, University Medical Center Utrecht, 3584 CX Utrecht, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Martijn M. A.","family":"Dietze","sequence":"additional","affiliation":[{"name":"Department of Radiology and Nuclear Medicine, University Medical Center Utrecht, 3584 CX Utrecht, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Camiel E. M.","family":"Kerckhaert","sequence":"additional","affiliation":[{"name":"Department of Radiology and Nuclear Medicine, University Medical Center Utrecht, 3584 CX Utrecht, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hugo W. A. M.","family":"de Jong","sequence":"additional","affiliation":[{"name":"Department of Radiology and Nuclear Medicine, University Medical Center Utrecht, 3584 CX Utrecht, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4735-655X","authenticated-orcid":false,"given":"Maarten L. J.","family":"Smits","sequence":"additional","affiliation":[{"name":"Department of Radiology and Nuclear Medicine, University Medical Center Utrecht, 3584 CX Utrecht, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,9,27]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"1386","DOI":"10.1093\/annonc\/mdw235","article-title":"ESMO consensus guidelines for the management of patients with metastatic colorectal cancer","volume":"27","author":"Cervantes","year":"2016","journal-title":"Ann. Oncol."},{"key":"ref_2","doi-asserted-by":"crossref","unstructured":"For the Italian Society of Locoregional Therapies in Oncology (SITILO), Cosimelli, M., Golfieri, R., Cagol, P.P., Carpanese, L., Sciuto, R., Maini, C.L., Mancini, R., Sperduti, I., and Pizzi, G. (2010). 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