Radioembolization with Intra-Arterial Angiotensin II to Improve Tumor-Absorbed Dose (RADIANT): A Single-Arm Phase II Study Protocol.
- 1Department of Radiology and Nuclear Medicine, University Medical Center Utrecht, 3584 CX Utrecht, The Netherlands.
Abstract
Purpose
The effectiveness of transarterial radioembolization (TARE) depends largely on the tumor-to-non-tumor ratio (TNR): the ratio of microsphere concentration between tumor and non-tumorous liver tissue. Angiotensin II (AT-II) may improve TNR by inducing vasoconstriction primarily in arteries supplying healthy liver parenchyma. Tumor-feeding arteries, lacking neurovascular innervation, are largely unresponsive to AT-II, potentially resulting in preferential blood flow redistribution toward tumor tissue. The RADIANT study aims to evaluate whether intra-arterial AT-II infusion prior to yttrium-90 (⁹⁰Y) microsphere injection improves tumor selectivity during TARE in patients with primary or metastatic liver tumors.Materials and methods
This single-center, single-arm phase II study will include 15 patients with primary or metastatic liver tumors (any histological subtype, diameter ≥ 2 cm) referred for ⁹⁰Y glass radioembolization. Each patient serves as their own control: during work-up, technetium-99m macroaggregated albumin (99mTc-MAA) is administered without AT-II and TNR is measured on SPECT/CT. During the therapeutic procedure, AT-II is infused intra-arterially (10 µg/min over 100 s) immediately before ⁹⁰Y microsphere injection, and TNR is measured on post-treatment ⁹⁰Y PET/CT. The primary endpoint is the TNR improvement factor (TNR after ⁹⁰Y + AT-II divided by TNR after 99mTc-MAA). Secondary endpoints include toxicity and technical success of AT-II administration.Discussion
The RADIANT study will provide prospective evidence on the effect of intra-arterial AT-II infusion on tumor selectivity during ⁹⁰Y radioembolization.
Related
- Does Concurrent Carotid Endarterectomy with Coronary Artery Bypass Grafting Improve Outcomes in Patients with Dual Arterial Disease? A Systematic Review and Meta-Analysis.
- Effect of dapagliflozin on renal response in patients with biopsy-confirmed lupus nephritis receiving stable maintenance immunosuppression and renin–angiotensin system inhibition: protocol for the multicentre randomised DAPA-LN trial
- Lipoprotein(a) and Coronary Artery Disease Polygenic Risk Scores Do Not Improve Secondary Manifestations of Arterial Disease Score Prediction of Coronary Events After Ischemic Stroke
- Culturally adapted home-based intervention to improve child’s development in Arab toddlers in Israel: study protocol for a randomized controlled trial
- Implementing a digitally enabled wound model of care to improve chronic wound outcomes in seven health services in Australia: study protocol for a multisite, hybrid type 2, two-phase effectiveness-implementation trial (the ENABLE study)
BibTeX
@article{wijnen2026radioembolization,
title = {{Radioembolization with Intra-Arterial Angiotensin II to Improve Tumor-Absorbed Dose (RADIANT): A Single-Arm Phase II Study Protocol.}},
author = {Niek Wijnen and Marnix G E H Lam and Khalil Ramdhani and Rutger C G Bruijnen and Martijn M A Dietze and Camiel E M Kerckhaert and Hugo W A M de Jong and Maarten L J Smits},
journal = {Cancers},
year = {2026},
month = sep,
doi = {10.3390/cancers18193129},
url = {https://europepmc.org/article/MED/42882823},
note = {CC BY},
}
RIS
TY - JOUR
TI - Radioembolization with Intra-Arterial Angiotensin II to Improve Tumor-Absorbed Dose (RADIANT): A Single-Arm Phase II Study Protocol.
AU - Niek Wijnen
AU - Marnix G E H Lam
AU - Khalil Ramdhani
AU - Rutger C G Bruijnen
AU - Martijn M A Dietze
AU - Camiel E M Kerckhaert
AU - Hugo W A M de Jong
AU - Maarten L J Smits
PY - 2026
DA - 2026/09/27
JO - Cancers
DO - 10.3390/cancers18193129
UR - https://europepmc.org/article/MED/42882823
AB - Purpose The effectiveness of transarterial radioembolization (TARE) depends largely on the tumor-to-non-tumor ratio (TNR): the ratio of microsphere concentration between tumor and non-tumorous liver tissue. Angiotensin II (AT-II) may improve TNR by inducing vasoconstriction primarily in arteries supplying healthy liver parenchyma. Tumor-feeding arteries, lacking neurovascular innervation, are largely unresponsive to AT-II, potentially resulting in preferential blood flow redistribution toward tumor tissue. The RADIANT study aims to evaluate whether intra-arterial AT-II infusion prior to yttrium-90 (⁹⁰Y) microsphere injection improves tumor selectivity during TARE in patients with primary or metastatic liver tumors.Materials and methods This single-center, single-arm phase II study will include 15 patients with primary or metastatic liver tumors (any histological subtype, diameter ≥ 2 cm) referred for ⁹⁰Y glass radioembolization. Each patient serves as their own control: during work-up, technetium-99m macroaggregated albumin (99mTc-MAA) is administered without AT-II and TNR is measured on SPECT/CT. During the therapeutic procedure, AT-II is infused intra-arterially (10 µg/min over 100 s) immediately before ⁹⁰Y microsphere injection, and TNR is measured on post-treatment ⁹⁰Y PET/CT. The primary endpoint is the TNR improvement factor (TNR after ⁹⁰Y + AT-II divided by TNR after 99mTc-MAA). Secondary endpoints include toxicity and technical success of AT-II administration.Discussion The RADIANT study will provide prospective evidence on the effect of intra-arterial AT-II infusion on tumor selectivity during ⁹⁰Y radioembolization.
SN - 2072-6694
ER -