Holmium Radioembolization as Adjuvant Treatment to RFA for Early Stage HCC: Dose Finding Study

Inclusion Criteria: * Informed consent * Age \> 18 years * Single HCC lesion with diameter of ≥ 2-5cm or up to three lesions with each lesion measuring no more than 3cm (confined to one lobe) * HCC diagnosis is based on histology or non-invasive imaging criteria according to EORTC-EASL guidelines * Child Pugh A or B ≤7 * ECOG performance status ≤ 2 * Bilirubin \< 2mg/dL * ASAT \< 5x upper limit of normal * ALAT \< 5x upper limit of normal * Thrombocytes ≥ 50 X 10\^9/L Exclusion Criteria: * Recurrent HCC * Tumor location precluding percutaneous RFA * Bilobar tumor involvement * Vascular tumor invasion or extrahepatic metastasis * Hemihepatectomy * Severe comorbidity (e.g. cardiovascular disease, diabetes with nephropathy, active infections) * Uncorrectable coagulopathy * Large arterio-portovenous shunt * Previous radiotherapy to the liver * Surgical hepatico-enterostomy * Hepatic resection with placement of surgical clips that may cause artefacts on MRI * Incompetent/ mentally disabled * Pregnancy, inadequate anticonception * Calculated lung dose \>30Gy * Creatinine clearance \< 50 ml/min