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IntroductionRadioembolisation of liver tumours demands many choices from the physician regarding planning of treatment and subsequent follow-up.MethodsAn online questionnaire was distributed amongst all members of the Cardiovascular and Interventional Radiological Society of Europe (CIRSE) to investigate the current state of radioembolisation practice.ResultsThe survey was completed by 60 centres. The increasing number of radioembolisation procedures may reflect that radioembolisation is increasingly recognised as a valuable treatment option in European cancer guidelines. Imaging modalities play an important role in decision making. Furthermore, there seems to be a trend towards less coil-embolisation of non-target vessels. In addition, type of microsphere, model for dose calculation, complications and future developments are evaluated in this article.ConclusionsThis survey provides insight into the current state of radioembolisation practice across Europe.Electronic supplementary materialThe online version of this article (10.1007/s00270-018-1982-4) contains supplementary material, which is available to authorized users.

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Safety and efficacy of 166 Ho-radioembolization was first determined in the HEPAR and HEPAR II studies, however excluding patients with hepatocellular carcinoma (HCC). The aim of this prospective clinical early phase II study was to establish the toxicity profile of 166 Ho-radioembolization in patients with measurable, liver-dominant HCC, BCLC stage B-C, Child-Pugh (CP) score ≤B7, ECOG 0-1 without curative treatment options.The primary endpoint was rate of unacceptable toxicity defined as grade 3 hyperbilirubinemia (Common Terminology Cancer Adverse Events version 4.03) in combination with low albumin and/or ascites in the absence of disease progression or treatment-related serious adverse events (SAEs). Secondary endpoints included overall toxicity, response, survival, change in α-fetoprotein (AFP), and quality of life.Thirty-one patients with BCLC stage B (71%) or C (29%) HCC were included, mostly multifocal (87%) bilobar (55%) disease. Common grade 1-2 clinical toxicity included fatigue (71%), back pain (55%), ascites (32%), dyspnea (23%), nausea (23%), and abdominal pain (23%), with no >10% grade 3-5 toxicity. Grade 3 laboratory toxicity (>10%) included AST and GGT increase (16%), hyperglycemia (19%), and lymphopenia (29%). Treatment-related unacceptable toxicity occurred in 3/31 patients. At three months, 54% of target lesions showed complete or partial response according to mRECIST. Median overall survival was 14•9 months (95% confidence interval (CI) 10•4 months-24.9 months). No significant changes in quality of life or pain were observed. 166 Ho-radioembolization safety was confirmed in HCC with <10% unacceptable toxicity. Efficacy data support further evaluation.

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