Radio-embolisation is the delivery of radioactive microspheres to cancers using an endovascular approach. It is often performed as an outpatient procedure.
- primary liver cancer or liver metastases
- bilirubin of < 2.0
- tumour size less that than 70% of the liver size
There are two absolute contraindications 1:
- excessive hepatopulmonary shunting (results in radiation pneumonitis)
- demonstrable gastrointestinal shunting (results in gastric ulceration)
- typically a trans-femoral intra-arterial catheter with the tip near the target lesion
- nuclear medicine specialists prepare the radioactive (e.g. yttrium-90) microspheres (about 32 microns), which when injected are implanted in the microvascular arterial supply of the tumor where they become trapped
The spectrum of yttrium-90 is ~2.7 days, with no remaining radioactivity after on month.
Treatment and prognosis
Overall survival rate of almost 13 months with radio-embolisation. Mortality ranges from 0.6% to 6% at 30 and 90 days, respectively in high-risk groups.
The most common adverse events are:
- abdominal pain