Radioembolization Practice in North America Versus Europe: Results from a Global Survey

Purpose: The Cardiovascular and Interventional Radiological Society of Europe (CIRSE) conducted an international survey on the real-life application of transarterial radioembolization (TARE). This sub-analysis of the complete survey evaluates intercontinental disparities in TARE practices. Materials and Methods: A survey of 32 multiple-choice questions was distributed to CIRSE members between November and December 2022. The questions addressed steps of the TARE workflow, including treatment work-up, planning and dosimetry, intervention, follow-up and innovations. Responses were curated to remove duplicates and incomplete entries and categorised into continental groups. Analysis focused on variations between Europe and North America and impacting factors in the respective regions were identified. Data is presented using descriptive statistics. Results: Responses were obtained from 30 countries and 133 hospitals, including 87 European and 21 North American centres. Hepatocellular carcinoma was the most common indication, constituting 61% of treatments in North America and 51% in Europe. North America predominantly used ⁹⁰Y glass microspheres, whereas Europe used ⁹⁰Y resin. Procedural differences included the adoption of intra-procedural CT imaging, utilized by all North American sites, versus 89% of European sites. Outpatient treatments were favoured in North America (85%), while in Europe, most patients remained hospitalized for one night (51%). Both regions increasingly emphasized dosimetry-guided treatments, with personalized dosimetry planning in 71% and 84% of North American and European sites, respectively. Conclusions: This North America–Europe comparison highlights regional differences in radioembolization practice between the leading continents in procedure volume, based on results of the CIRSE TARE survey. Specific intercontinental differences identified in this survey included hospitalization, product utilization, and procedural techniques.