Yttrium-90 Microsphere Radioembolization

Yttrium-90 microsphere radioembolization is an FDA approved, non-surgical procedure used to treat inoperable liver cancer. This innovative procedure delivers targeted, internal radiation therapy directly to the tumor.

With yttrium-90 microsphere radioembolization, a catheter is inserted through a tiny incision in the groin and threaded through the arteries until it reaches the hepatic artery. The hepatic artery is one of two blood vessels that feed the liver and the one that usually supplies blood to the tumors. Once the catheter is properly placed in the hepatic artery, millions of tiny beads, or microspheres, which contain the radioactive element yttrium-90, are released into the blood stream. These microspheres lodge into the smaller blood vessels that feed the tumor. In addition to preventing blood flow to the tumor, the microspheres emit radiation that helps destroy the cancerous cells. The radiation only penetrates approximately 1/16” of tissue, so very little healthy liver tissue is affected by the radiation.

Due to the targeted nature of this approach, it can deliver a much more potent dose of radiation than conventional radiation therapy. The radiation in the yttrium-90 continually decreases over a 2 week period, at which time the radiation is essentially gone. The microspheres will remain in the liver without causing any complications.

Yttrium-90 microsphere radioembolization may require two treatments. The right and left lobes of the liver are usually treated separately, with at least one month between the treatments.

This minimally-invasive treatment has few side effects. It can be used to treat both primary and secondary liver cancer. While it won’t cure the cancer, it can shrink tumors, improve the quality of life, and possibly extend life for people with inoperable liver cancer.

One of INVISION's interventional radiologists, Dr. Charles Nutting, was the first in the nation to perform this progressive procedure. Read more about this procedure and Dr. Nutting in the article "Life-Extending Technology Close to Home" written for the Sky Ridge Medical Center Cancer Center.

This page contains the following information about yttrium-90 microsphere radioembolization:

Reasons for Getting Yttrium-90 Microsphere Radioembolization

Yttrium-90 microsphere radioembolization is used to treat liver cancer in patients who cannot have the tumors surgically removed. It may also be used to shrink tumors prior to surgery.

Not everyone with inoperable liver cancer is a candidate for this procedure. If you are a candidate, your doctor may recommend this procedure over other non-surgical treatments for the following reasons:

Risks Involved in Yttrium-90 Microsphere Radioembolization

Since a catheter is placed within the blood vessels, there is a risk of damage to a blood vessel, bruising or bleeding at the puncture site, or infection.

You could have an allergic reaction to the contrast material used during the procedure.

Serious side effects in the gastrointestinal tract or lungs are possible if the microspheres are not correctly placed in the liver. These are uncommon and usually only occur in patients who have unusual or severely damaged blood vessels in the liver.

Conditions to Let Our Doctor Know About

In advance of your exam, let your INVISION radiologist or technologist know if any of the following circumstances apply to you:

Insurance Coverage for Yttrium-90 Microsphere Radioembolization

Yttrium-90 microsphere radioembolization has been approved for Medicare reimbursement and is covered by many insurance carriers. Check with your insurance carrier to be sure.

Procedure Locations

Consultations for yttrium-90 microsphere radioembolization are done at the INVISION Vascular & Interventional Clinic.

The procedure is performed at the following INVISION partner hospitals in the Denver, Colorado area:

Please note:

INVISION is partially owned by Radiology Imaging Associates (RIA); consequently, your radiologist’s lab coat and your bill, if you receive one, may say RIA rather than INVISION.

Scheduling Yttrium-90 Microsphere Radioembolization

To schedule a consultation to discuss yttrium-90 microsphere radioembolization, call 720-493-3406.

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Preparing for Yttrium-90 Microsphere Radioembolization

Following are the preparation guidelines for yttrium-90 microsphere radioembolization. Please contact us at 720-493-3406 if you have any questions.

What to Expect During Your Procedure

Before scheduling the procedure, an INVISION radiologist must determine if you are a good candidate for yttrium-90 microsphere radioembolization. You will need to supply INVISION with numerous medical records and test results so your eligibility can be determined.

If you appear to be a candidate, you will undergo additional exams including a blood test and a CT scan or PET scan . These exams will help the radiologist confirm your eligibility for the yttrium-90 microsphere radioembolization and determine an appropriate radiation dose for your liver. If your eligibility is confirmed and you decide to have the procedure, you must also have an angiogram 7-10 days before the procedure date.

When you come in for the procedure, you will be asked to change into a gown. After answering any questions you have, a technologist will start an intravenous (IV) line in your arm. He or she will set up various devices so your heart rate and blood pressure can be monitored throughout the procedure. You will remain awake for the procedure, but you will be given conscious sedation through the IV to help you relax.

The site of the groin incision will be cleansed. A fluoroscope will be moved into position above your abdomen. The radiologist will then make the incision and insert the catheter. While watching the fluoroscope images, he or she will carefully guide the catheter to the hepatic artery in the liver.

After the catheter is properly placed, the radiologist will deploy the microspheres through the catheter and into the hepatic artery. After all the microspheres have been deposited, the catheter will be withdrawn and the incision cleaned and taped.

This procedure is generally painless; however, some patients experience pain when the microspheres are deployed. Let the radiologist known immediately if you feel any pain.

The procedure takes 30-60 minutes to complete. You will then spend 2-6 hours in the recovery area. Many patients go home the same day of the procedure, but some are required to stay overnight for observation.

Recovering from Your Procedure

Most patients return to their normal activities after leaving the hospital. All patients will experience fatigue for 1-4 weeks following the therapeutic injection. Some patients may also experience a low-grade fever, nausea, vomiting, loss of appetite, or abdominal pain after the procedure. These side effects usually subside within 3-5 days and some may be alleviated with medication. If they last more than 7-10 days, inform your doctor.

There are certain precautions you should take for one week after your treatment for the safety of your family and other people. Do not use public transportation that will require you to sit next to another person for more than two hours. Do not sleep in the same bed as your partner. Avoid close contact with pregnant women and children. For the first three days, maintain a 6-foot distance from other adults if contact will last for more than a few minutes.

Follow-Up for This Procedure

Every three months after therapy, a CT scan, MRI or PET scan will be performed.

Additional Information

The information on this page was taken in part from some of the following web sites. Visit these sites for additional information on yttrium-90 microsphere radioembolization.

Sources

Yttrium-90 microsphere radioembolization is performed in a hospital using a fluoroscope to take real-time x-rays of the body during the procedure. Radioactive microspheres are deployed through a catheter into the blood vessels that feed the tumor