Voxel-based dosimetry for predicting treatment response to transarterial radioembolization in hepatocellular carcinoma: significance of intratumoral dose distribution

Voxel-based dosimetry using multiple VSV kernels enables quantitative assessment of intratumoral dose distribution in HCC patients treated with TARE. Among voxel-level parameters, D70, V-V₂₀₅, and CoV showed good performance in predicting CR, and V-V₂₀₅ was the only independent predictor for both treatment response and L-PFS. These findings support the added prognostic value of voxel-based dose metrics beyond average tumor absorbed dose.