Streamlined Resin Y90 Radiation Segmentectomy for Small HCC: One & Done Trial

Inclusion Criteria

• * 18 years of age or older * Has focal HCC (≤ 5 cm or ≤ 3 tumors ≤ 3 cm; confined to 1 or 2 anatomical segments of the liver) and is deemed to benefit from Y90 radioembolization by institutional multidisciplinary tumor board

Exclusion Criteria

• * The presence of trans-jugular intrahepatic portosystemic shunt (TIPS) * Total bilirubin level > 3.0 mg/dL * Serum albumin level < 2.5 g/dL * Aspartate and alanine aminotransferase levels no greater than five times the normal level * Life expectancy < 12 weeks * Eastern Cooperative Oncology Group performance status > 2 * Patients with chronic lung disease requiring supplemental oxygen at baseline or baseline SpO2 of < 92% * Patients that have tumors with central anatomical locations close the hepatic hilum or caudate lobe, and those with early/arterial enhancement of hepatic vein, IVC, or portal vein on multiphase contrast enhanced CT or MRI * Patients with macrovascular invasion on baseline imaging * Known hypersensitivity to iodinated contrast agents or to any component of iodinated contrast agents refractory to standard medications (antihistamines, steroids) * Impaired kidney function (glomerular filtration rate < 30 as approximated using serum creatinine levels) unless anuric and on dialysis. * Any woman who is pregnant or has reason to believe she is pregnant (the possibility of pregnancy has to be excluded by negative urine β-HCG results, obtained within 48 hours prior to the treatment or on the basis of patient history, e.g.: tubal ligation, hysterectomy or a minimum of 1 year without menses)