Radioembolization of Liver Tumors

What is Radioembolization of Liver Tumors?

Radioembolization is a minimally invasive treatment for cancerous tumors of the liver.  During a radioembolization an Interventional Radiologist uses imaging techniques to guide a catheter to the artery that feeds the liver tumor.   Small particles that have been filled with yttrium (Y-90), a radioactive isotope, are injected directly into the artery.  This treatment method delivers high dose radiation directly to the tumor.  

How is the Procedure Performed?

At Tufts Medical Center radioembolization of liver tumors is performed by a specially trained radiologist in the Interventional Radiology department. This procedure typically takes place on an outpatient basis, and is done in two sessions. On the day of the procedures you will have blood samples drawn and will be prepared by the nursing staff in the CVC Suite.  The procedure is performed under sedation; a radiology nurse will administer medications through your intravenous to keep you comfortable.  Once you are positioned on the procedure table your groin will be cleansed and sterilized.  Your physician will then numb the skin and make a small nick in the skin where the catheter will be inserted into your artery.  During the first visit, the mapping procedure, your physician will visualize all of the arteries of the upper abdomen.  At that time the arteries flowing to the stomach and lungs are blocked with small wire coils to prevent the flow of radioactive particles to those organs.  Once your physician has determined that flow to the liver tumor is isolated, a nuclear medicine tracer is injected to simulate treatment.  A nuclear scan will be performed to verify that there is no flow of the tracer to either the stomach or lungs.  

During the second visit you will be prepared as you were for the mapping procedure.  After the catheter is inserted in your groin the physician will use X-ray to guide the catheter to the artery that feeds the tumor. The tumor can then be treated with Y-90, delivering radiation directly to the cancerous cells, cutting off blood supply to the tumor in the process.  Once the radiologist has treated the liver tumor the catheter is removed and pressure is applied to the arterial puncture site to prevent bleeding.  You will again have a nuclear scan to verify that the radioisotope was delivered to the liver tumor and not to any other organs.  

What Should I Expect After the Procedure?

At the completion of the procedure you will be monitored in the CVC Suite for approximately 4 hours, during which time you will be required to lie flat.  You may experience some discomfort after the procedure which will be controlled with pain medications given to you through either your intravenous or by mouth.  After you have completely recovered from the procedure you will be discharged home with a friend or family member.  It is expected that you will be able to return to normal activity within a few days after your RFA.

What are the Risks of Radioembolization?

• Infection
• Post embolization syndrome – pain, fever, nausea
• Damage to the blood vessels
• Bleeding
• Non-target embolization
• Decreased liver functions