Computational Fluid Dynamics Models for Patient-Specific Planning of Liver Transarterial Radioembolization

Abstract

Transarterial therapies, such as transarterial radioembolization (TARE) and chemoembolization (TACE) are the preferred methods of treatment at the unresectable intermediate stage of hepatocellular carcinoma (HCC), the most common form of primary liver cancer. During these catheter-directed therapies, microspheres are injected superficially or selectively in the hepatic arteries with the goal of locally embolizing the tumor tissue, which is mainly fed arterially. However, the treatment outcomes (mean survival times) of TARE and TACE are highly heterogeneous, with many patient-specific aspects, such as commonly varying hepatic arterial anatomies and tumor size(s) and location(s), complicating treatment execution. Additionally, both computational, experimental and clinical studies have shown that several clinical injection parameters (e.g. injection location, injection flow rate, catheter type), which typically vary in clinical practice, can have a large impact on the downstream microsphere distribution.