Radioembolisation Therapy for Liver Cancer

Radioembolisation is a procedure that uses microspheres (tiny glass or resin spheres) that contain the radionuclide Yttrium-90.  These are used to treat patients with liver cancer, and are injected via an artery directly into the liver.  Yttrium-90 releases short-range radiation that damages nearby cells. Because the microspheres accumulate to a greater extent in liver tumours than in normal liver tissue, the radiation damages the cancer whilst sparing nearby healthy tissue.  There are two types of microspheres used: SirSpheres® and Theraspheres®. They are both very similar in the way they work.

The procedure is carried out in two stages, usually one to three weeks apart. Both procedures are carried out in a theatre in the Radiology Department, and are followed by a scan in the Nuclear Medicine Department.

The first stage is called the “work-up”, or pre-therapy appointment.

During the work-up stage, the treatment is simulated using a radioactive tracer injected into the liver via the hepatic artery. The tracer consists of tiny particles that get stuck in the small blood vessels in liver tumours. Once the tracer has been injected, the patient is scanned on a gamma camera in the Nuclear Medicine Department.  The pictures show whether the tracer has properly targeted the cancer, and checks to see if a significant amount has accumulated in the lungs. If this is the case, the therapy may not be able to go ahead as the radiation dose to the lungs would be too large.  After the scan, the patient may stay overnight on a ward or may be able to go home later the same day.

During the therapy stage, a similar procedure is followed, but this time the Yttrium-90 microspheres are injected. The microspheres get stuck in the small blood vessels and give a radiation dose to the liver tumours. The patient stays overnight on a ward and is scanned the following day in the Nuclear Medicine Department, to confirm that the microspheres have gone to the intended areas.

Upon discharge, patients are given radiation protection advice by a Medical Physicist. Since the therapy agent is radioactive, some simple precautions may need to be followed.

More detailed information on this therapy can be found in the Patient Information Leaflet.

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