Transarterial 90yttrium radioembolisation

Abstract

The term transarterial radioembolisation includes those procedures in which intra-arterially injected radioactive microspheres are used for internal radiation purposes. This procedure aims to selectively target radiation to liver tumours and to limit the dose involving the normal liver parenchyma. The yttrium-90 microspheres delivered through the hepatic artery are implanted into liver tumours in a ratio ranging from 3:1 to 20:1 as compared to a normal liver. A work-up, involving computed tomography scanning, contrast-enhanced magnetic resonance imaging and hepatic angiography, is essential for assessing the appropriateness of yttrium-90 treatment for each patient. A simulation of the procedure, carried out with technetium-99 m-labelled macroaggregated albumin particles, which approximate the size of microspheres, is used to identify the shunting of microparticles to the lungs or the gastrointestinal tract, thus helping in patient selection.