Radiation segmentectomy for hepatic malignancies: Indications, devices, dosimetry, procedure, clinical outcomes, and toxicity of yttrium-90 microspheres

Radiation segmentectomy (RS) is a new approach to 90Y radioembolization that has been designed to increase the safety and efficacy of radioembolization in patients with unresectable hepatic malignancies. With this technique, high doses (>190 Gy) of radiation are delivered to the tumor through radioembolization performed in a segmental fashion, potentially increasing the radiation dose to the tumor while minimizing injury to the liver parenchyma. The aim of this review is to provide a summary of the indications, device choice, dosimetry, procedure, clinical outcomes, and toxicity of RS based on the clinical series currently available.