Purpose: Strategies for the treatment of liver metastases from colon cancer (lmCRC) are constantly evolving. Radioembolization with yttrium 90 (Y-90 TARE) has made significant advancements in treating liver tumors and is now considered a potential option allowing for future resection. This study reviewed the scientific evidence and developed recommendations for using Y-90 TARE as a treatment strategy for patients with unresectable lmCRC. Methods: A multidisciplinary scientific committee, consisting of experts in medical oncology, hepatobiliary surgery, radiology, and nuclear medicine, all with extensive experience in treating patients with ImCRC with Y-90 TARE, led this project. The committee established the criteria for conducting a comprehensive literature review on Y-90 TARE in the treatment of lmCRC. The data extraction process involved addressing initial preliminary inquiries, which were consolidated into a final set of questions. Results: This review offers recommendations for treating patients with lmCRC using Y-90 TARE, addressing four areas covering ten common questions: 1) General issues (multidisciplinary tumor committee, indications for treatment, contraindications); 2) Previous process (predictive biomarkers for patient selection, preintervention tests, published evidence); 3) Procedure (standard procedure); and 4) Post-intervention follow-up (potential toxicity and its management, parameters for evaluation, quality of life). Conclusions: Based on the insights of the multidisciplinary committee, this document offers a comprehensive overview of the technical aspects involved in the management of Y-90 TARE. It synthesizes recommendations for applying Y-90 TARE across various phases of the treatment process.

Objectives: to present an interventional radiology standard of practice on the use of inferior vena cava filters (IVCFs) in patients with or at risk to develop venous thromboembolism (VTE) from the Iberoamerican Interventional Society (SIDI) and Spanish Vascular and Interventional Radiology Society (SERVEI). Methods: a group of twenty-two interventional radiologist experts, from the SIDI and SERVEI societies, attended online meetings to develop a current clinical practice guideline on the proper indication for the placement and retrieval of IVCFs. A broad review was undertaken to determine the participation of interventional radiologists in the current guidelines and a consensus on inferior vena cava filters. Twenty-two experts from both societies worked on a common draft and received a questionnaire where they had to assess, for IVCF placement, the absolute, relative, and prophylactic indications. The experts voted on the different indications and reasoned their decision. Results: a total of two-hundred-thirty-three articles were reviewed. Interventional radiologists participated in the development of just two of the eight guidelines. The threshold for inclusion was 100% agreement. Three absolute and four relative indications for the IVCF placement were identified. No indications for the prophylactic filter placement reached the threshold. Conclusion: interventional radiologists are highly involved in the management of IVCFs but have limited participation in the development of multidisciplinary clinical practice guidelines.

Background: The present study aims to investigate the superiority of TARE-Y90 in the treatment of liver metastases from colorectal cancer in comparison to DEBIRI and perform a parallel resource consumption study to demonstrate a possible favorable cost-effectiveness balance. Methods: The number of subjects included in this study was 46 for TARE-Y90 and 56 in the DEBIRI group. The variables of interest in this study were collected for all selected subjects. Time-to-endpoint outcomes (overall survival, time to progression and time to extra-hepatic progression) were calculated by Kaplan–Meier analysis, reported as medians with 95% confidence intervals and compared between groups by log-rank testing. Values for median time-to-event and 95% confidence intervals were calculated using bootstrapping. Results: Categorization into overall response (OR) and no overall response (NOR) revealed a higher percentage of overall responses in the DEBIRI group (52%) compared to TARE-Y90 (24%). The numerical differences observed in certain response categories did not reach statistical significance, indicating a comparable overall response to treatment between the two cohorts based on the m-RECIST criteria. Median overall survival for the TARE-Y90 cohort was 11.3 (95% CI 10.9–18.6) months and 15.8 (95% CI 14.8–22.7) months for the DEBIRI cohort. Log-rank testing showed no statistically significant differences (p = 0.53). Median time to hepatic disease progression for the TARE-Y90 cohort was 3.5 (95% CI 3.4–8.1) months and 3.8 (95% CI 3.7–11.1) months for the DEBIRI cohort. Log-rank testing showed no statistically significant differences (p = 0.82). An important result of the resource utilization analysis is that TARE-Y90 patients had 1.33 treatments on average per patient, while DEBIRI patients had 3.16 treatments per patient. TARE-Y90 patients also needed fewer days of hospitalization than those in the DEBIRI group. The consequence is that the overall use of resources was higher for DEBIRI in comparison to TARE-Y90. Conclusions: Our analysis of the TARE-Y90 and DEBIRI treatments for CRC liver metastases contributes valuable insights into their comparative effectiveness, revealing no significant differences in radiological responses and overall survival. TARE-Y90 showed higher resource utilization, and its potential advantages in patient comfort and average resource consumption per patient warrant consideration.

Purpose: The present study aims to investigate superiority of TARE-Y90 in the treatment of liver metastases from colorectal cancer in comparison to DEBIRI and perform a parallel resource consumption study to demonstrate a possible favorable cost-effectiveness balance. Material and Methods: The number of included subjects in the study was 46 for TARE-Y90 and 56 in the DEBIRI group. Variables of interest in the study were collected for all selected subjects. Time-to-endpoint outcomes (overall survival, time to progression and time to extra-hepatic progression) was calculated by Kaplan-Meier analysis and reported as a median with 95% confidence interval and compared between groups by log-rank testing. Survival analyses were performed using R package “survival” 3.5-7. Values for median time-to-event and 95% confidence intervals were calculated using bootstrapping. Results: The categorization into overall response (OR) and no overall response (NOR) revealed a higher percentage of overall responses in the DEBIRI group (52%) compared to TARE-Y90 (24%). The numerical differences observed in certain response categories did not reach statistical significance, indicating a comparable overall response to treatment between the two cohorts based on the m-RECIST criteria. Median overall survival for the TARE-Y90 cohort is 11.3 (95% CI 10.9 – 18.6) months, and 15.8 (95% CI 14.8 – 22.7) months for the DEBIRI cohort. Log-rank testing shows no statistically significant differences (p = 0.53). Median time to hepatic disease progression for the TARE-Y90 cohort is 3.5 (95% CI 3.4 – 8.1) months, and 3.8 (95% CI 3.7 – 11.1) months for the DEBIRI cohort. Log-rank testing shows no statistically significant differences (p = 0.82). An important result of the resource utilization analysis is that TARE-Y90 patients have 1.33 treatments on average by patient, while DEBIRI patients have 3.16 treatments per patient.DEBIRI patients require more than 2 days in the intensive care unit on average, while it is not necessary for TARE-Y90. TARE-Y90 patients also need less days of hospitalization than those of DEBIRI. The consequence is that the overall use of resources is higher for DEBIRI in comparison to TARE-Y90. Conclusion: TARE-Y90 and DEBIRI treatments for CRC liver metastases contributes valuable insights into their comparative effectiveness, revealing no significant, differences in radiological responses and overall survival. TARE-Y90 showed higher resource utilization, its potential advantages in patient comfort and average resource consumption per patient warrant consideration.

RESUMEN El interés creciente de los sistemas de salud, sociedades médicas y administraciones sanitarias, ha impulsado en los últimos años el continuo análisis, así como el diseño de planes de acción en temas tan prevalentes como el manejo de trauma grave. En esta ocasión se presenta y destacan aquellos aspectos más significativos, así como los niveles de evidencia en el manejo del trauma por parte de radiología intervencionista; estos lineamientos aparecen reflejados desde principios de año 2020 en el Proceso Asistencial Integrado (PAI) parte del III Plan Andaluz de Salud con el objetivo de contribuir a la disminución de la morbimortalidad en esta patología. La radiología intervencionista desempeña un papel significativo en el proceso, lo cual mejora los resultados y permite a su vez una mayor participación futura supeditada a