Radioembolization for HCC Patients With Personalized Yttrium-90 Dosimetry for Curative Intent (RAPY90D)

Inclusion Criteria:

1. Patients over 18 years of age, of any race or sex, who have unresectable hepatocellular carcinoma of the liver, and who are able or have a fully able legal guardian to give informed consent, will be eligible. Patients must have an ECOG Performance Status score of \</=2, with a life expectancy of \>/=3 months, and must be non-pregnant with an acceptable contraception in premenopausal women. Patients must be \>4 weeks since prior radiation or prior surgery and at least one month post chemotherapy.
2. At least one lesion \>/= 3.0 cm in shortest dimension
3. AST or ALT \<5 times ULN
4. Bilirubin \</= 2.0 mg/dL (unless segmental infusion is used)
5. Negative pregnancy test in premenopausal women

Exclusion Criteria:

1. Contraindications to angiography and selective visceral catheterization
2. Evidence of potential delivery of greater than 16.5 mCi (30 Gy absorbed dose) to the lungs with a single injection, or greater than 50 Gy for multiple injections
3. Evidence of any detectable Tc-99m MAA flow to the stomach or duodenum, after application of established angiographic techniques to stop or mitigate such flow (eg, placing catheter distal to gastric vessels)
4. Significant extrahepatic disease representing an imminent life-threatening outcome
5. Severe liver dysfunction or pulmonary insufficiency
6. Active uncontrolled infection
7. Significant underlying medical or psychiatric illness
8. Pregnant
9. Pre-existing diarrhea/illness, co-morbid disease or condition that would preclude safe delivery of TheraSphere® treatment and place the patient at undue risk
10. Infiltrative tumors