Radioembolization (ray-dee-oh-em-beh-lih-ZAY-shun) is a procedure used to treat some kinds of liver tumors.
A specialized doctor, called an interventional radiologist, injects tiny beads containing radioactive material into a blood vessel that leads to the tumor. The radioactive material, yttrium-90 (Y90), works right on the tumor and not the healthy tissue around it.
The full name of this treatment is transarterial radioembolization with yttrium-90 (TARE-Y90).
Radioembolization goes through a blood vessel and right to the liver tumor. The radioactive material doesn't pass through healthy parts of the body to reach the cancer cells, as happens in other kinds of radiation treatments.
Sometimes doctors use radioembolization with other treatments, like chemotherapy and surgery.
What Happens Before Radioembolization?
The interventional radiologist will explain the risks and likely benefits of radioembolization. If you decide the procedure is right for your child, you'll be asked to sign a consent (permission) form. Then, you will schedule the procedure.
Before the procedure, the care team will let you know:
if your child needs to stop any medicines
when your child should stop eating and drinking
whether your child will stay in the hospital or go home after the procedure
how to care for your child after the procedure
A week or two before the procedure, the interventional radiologist will do an angiogram (a special X-ray) to make a map of the tumor's blood vessels. The doctor will inject a dye called contrast as part of this mapping. They may also block off vessels to prevent radioactive particles from spreading to other parts of the body.
How Is Radioembolization Done?
Your child will have the procedure in a room called an interventional radiology suite (IR suite). It's like an operating room with extra X-ray and ultrasound equipment. Besides the interventional radiologist, other professionals work as a team to help your child:
nurses and assistants
technologists (equipment specialists)
Before going into the IR suite, the care team will:
Place an intravenous (IV) line in one of your child's veins (if a line is not already in place).
Put medicine (anesthesia) into the IV so your child will fall asleep.
The anesthesiology team will bring your child to the IR suite. For most radioembolization procedures, the interventional radiologist will:
Put a thin into your child's femoral artery, a large blood vessel near the groin (where the lower belly meets the upper thigh).
Use X-ray images and videos to guide the catheter's tip to the blood vessels being treated.
Inject tiny particles containing the Y90.
Can I Stay with My Child During Radioembolization?
You can stay with your child until it's time to go to the IR suite. Then, you'll move to the waiting area.
After the procedure, you'll go to the recovery room to be there as your child wakes up from the anesthesia. Because the Y90 isn't throughout the body, kids don't need to be isolated. They'll get regular nursing care as they recover.
How Long Does Radioembolization Take?
Radioembolization can take from 1 to 3 hours. It depends on how many tumors are being treated and where they are.
What Happens After Radioembolization?
For a few days after the procedure, your child may have:
mild belly pain that could include nausea and vomiting
Because the radioactive beads are deep inside the liver, very little radiation leaves your child's body. Most of the radioactivity fades from the beads in 7–10 days. Doctors don't remove the beads. The radiation may keep working on the tumor(s) for several weeks.
Are There Any Risks From Radioembolization?
Yes. Problems aren't common, but they can sometimes happen. They can include:
infection, bleeding, or blood vessel damage at the site the catheter entered the groin
damage to another part of the body (such as the lungs, stomach, intestine, or pancreas) if the radiation moves out of the targeted area
liver or gallbladder problems
an allergic reaction or kidney problem from the contrast dye used to see the blood vessels
a lowered number of infection-fighting cells in the blood (leukopenia)