Supplementary Materials s2

Supplementary materials

Histological comparison of kidney tissue following radioembolization with yttrium-90 resin microspheres and embolization with bland microspheres

Supplement Table 1. Summary of renal pathology gross macroscopic findings with 90Y-resin microspheres (active) and bland microspheres at

8–9 weeks

Animal 1 2 3 4 5 6 Active Lower pole scar Nodular Lower pole atrophic Upper pole Small lobulated Pale upper pole

pale upper irregular flattened nodular mid and

and mid lower pole

pole Bland Variegated pale Smooth Smooth surface Smooth Smooth minor Pale areas

with pale with small lobulation thinned cortex

blotchy scars upper and mid

areas pole Supplement Table 2. Microscopic features and morphological changes in each pole at 8-9 weeks

3a. 90Y-resin microspheres (active treatment)

Animal (Implanted activity and location)

1 2 3 4 5 6

0.15 GBq, left 0.2 GBq left upper 0.25 GB,q left 0.3 GBq, right 0.325 GBq left 0.35 GBq left

lower pole pole lower pole upper pole lower pole upper pole Upper Microsphere Scarce individual Many especially in Few, individual Moderate in Moderate Many in vessels,

Pole number, in glomeruli vessels associated with glomeruli and individual and including intima

distribution fibrosis scars aggregates in clusters of medium

vessels arteries Glomeruli No abnormality Fibrinoid necrosis, Focal minimal Fibrinoid No abnormality Prolifertive

sclerosis, fibrosis necrosis and necrosis, changes and

proliferation cellular fibrosis

mesangial

proliferation Reaction None Large wedge shaped Minimal fibrosis Wedge-shaped Moderate Extensive

scar with fibrosis and fibrous scars, subcapsular fibrosis, loss of

atrophy interstitial scars tubules.

fibrosis. Xanthomatous

Mild chronic

inflammation,

intimal

proliferation in

vessels most

marked near

aggregates of

microspheres in

vessels Middle Microsphere Few individual Few Many in clusters Few individual Large Many in clusters

Pole number, in vessels and clusters aggregates in

distribution vessels plus interstitial

aggregates Glomeruli Rare sclerotic, Mild necrosis and Marked necrosis Occasional Marked Proliferative

most normal fibrosis and cellular areas of necrosis sclerosis changes and

proliferation and cellular fibrosis

proliferation Reaction Nil Mild subcapsular Wedge-shaped Mild Large scars with Large scars,

scarring marked fibrosis, inflammation fibrosis, fibrosis,

fibrosis, atrophy around some atrophy, and histiocytes with

assoc with large vessels. Little histiocyte xanthomatous

numerous m/s fibrosis aggregates areas, chronic

inflammation Lower Microsphere Many, mainly Few individual Occasional Few individual, Large Many

Pole number, clusters in vessels diffusely in aggregates in

distribution glomeruli vessels Glomeruli Atropic in scar, No abnormality No abnormality Occasional Marked Segmental

otherwise normal areas of necrosis Sclerosis proliferative

and cellular changes and proliferation fibrosis Reaction Large area of None None Areas of Large wedge- Segmental large

atrophy and subcapsular shaped scars scars

fibrosis; some fibrosis with fibrosis

foreign body and atrophy

reaction Ureter Microsphere Present. Isolated Present occasionally in Present in None Present in Present in

number, plus some muscle only muscle and muscle only muscle and

distribution vascular clusters adventitial intima of artery

vessels. Reaction None None Some multi None Slight chronic Patchy moderate

nucleated cells inflammation chronic

inflammation 3b. Bland microspheres

1 2 3 4 5 6

2.13 million, 2.83 million right upper 3.54 million, 4.25 million, 4.6 million, 4.96 million,

right lower pole pole right lower left upper pole right lower right upper

pole pole pole Upper Microsphere Moderate Occasional individual Few in vessels Marked Moderate Few in vessels

Pole number, numbers in and glomeruli aggregates in aggregates and glomeruli

distribution afferent arterioles vessels and

of glomeruli some glomeruli Glomeruli No abnormality No abnormality No abnormality No abnormality, No abnormality No abnormality

No necrosis Reaction None None None Minor chronic Patchy sub- None

inflammation in capsular

interstitium. No scarring

fibrosis Middle Microsphere Moderate, Moderate individual Occasional Moderate in Aggregates in Moderate

Pole number, diffusely in individual vessels and vessels and aggregates in

distribution glomeruli glomeruli interstitium vessels and assoc with giant glomeruli

cell reaction Glomeruli No abnormality No abnormality No abnormality No abnormality No abnormality No abnormality Reaction None None None None. No Minor None

fibrosis subcapsular

scarring Lower Microsphere Marked clusters Moderate individual Occasional Few in vessels Occasionally in Moderate

Pole number, in vessels individual and glomeruli vessels and aggregates in

distribution glomeruli vessels and

glomeruli Glomeruli No abnormality No abnormality No abnormality No abnormality No abnormality No abnormality Reaction Subcapsular None None None, No Minor None

scarring with fibrosis subcapsular

foreign body scarring

giant cell

reaction Ureter Microspheres Present Few individual Present Few individual, Few individual. Occasionally in Occasionally in

individual in in muscle and adventitial Present in Present in muscle muscle

lamina propria vessels muscle and muscle and muscle adventitial

vessels Reaction None No fibrosis - None Mild chronic None

muscle appears inflammation

normal