Radioembolisation (SIRT, Y-90) for Liver Tumours

Radioembolisation, also called selective internal radiation therapy (SIRT) or TARE, delivers millions of microscopic beads loaded with radioactive yttrium-90 directly into the arteries feeding liver tumours. The beads lodge in the tumour's small vessels and irradiate it from within over about two weeks, while the rest of the liver receives far less.

It can shrink or control primary liver cancer and liver metastases, sometimes enough to allow surgery or transplant later. It treats the liver only, is usually a controlling rather than curative treatment, and is unsuitable if liver function is already poor.

What Radioembolisation (SIRT, Y-90) for Liver Tumours involves

Treatment is done in two visits to the angiography suite. In the first, the mapping session, an interventional radiologist passes a fine catheter from the groin or wrist artery into the liver arteries, studies the tumour's blood supply, may block small branches leading to the stomach or bowel, and injects a harmless tracer. A nuclear medicine scan then shows how much tracer escapes to the lungs and allows the dose to be calculated. One to three weeks later, the catheter is placed in the same position and the yttrium-90 microspheres are infused slowly over 10 to 20 minutes. A scan afterwards confirms where the beads have settled.

Who is a good candidate for Radioembolisation (SIRT, Y-90) for Liver Tumours?

Suitability is decided by a multidisciplinary liver tumour board, based on scans, liver blood tests and your general fitness.

• Hepatocellular carcinoma that cannot be removed or ablated, including some cases with portal vein involvement
• Bowel cancer metastases confined mainly to the liver that are no longer responding to chemotherapy
• Neuroendocrine tumour metastases and intrahepatic cholangiocarcinoma in selected patients
• Large tumours on one side, to shrink them and enlarge the healthy side before surgery

It is usually not the right choice if:

• Decompensated liver disease with jaundice, fluid in the abdomen or a high bilirubin
• A high lung shunt on the mapping scan, which would expose the lungs to radiation
• Extensive disease outside the liver that dominates the outlook
• Pregnancy, and people whose blood vessels cannot be safely catheterised

Technique options

• Resin microspheres: Smaller dose per bead and more beads. Commonly used for metastases.
• Glass microspheres: Higher activity per bead with less embolic effect. Often chosen for hepatocellular carcinoma.
• Radiation segmentectomy: A very high dose given to one or two small liver segments with the aim of destroying a limited tumour completely.
• Alternatives: TACE, ablation, systemic therapy: Chemoembolisation, thermal ablation or drug treatment may be preferred depending on tumour size, number and liver reserve.

What happens during your treatment

Each session lasts 60 to 90 minutes under local anaesthesia with light sedation. You may feel warmth from contrast dye and mild upper abdominal ache during the infusion. Afterwards you lie flat for a few hours if the groin was used. Most people go home the same day or after one night.

Preparing for your trip

Plan for two procedures 1 to 3 weeks apart: mapping, then treatment. Some people stay in Istanbul for the whole period of about 2 to 3 weeks; others make two short trips. If both liver lobes need treating, the second lobe is done 4 to 6 weeks later. The first response scan is at about 3 months and can be done at home and shared.

• Tell the doctor about medication, allergies, pregnancy or breastfeeding, and any history of cold sores, keloid scars or autoimmune disease
• Avoid alcohol, aspirin and anti-inflammatory painkillers for a few days beforehand if your own doctor agrees, to reduce bruising
• Arrive without make-up on the treatment area and avoid sunbeds and strong sun for two weeks before

Recovery and results

Tiredness, reduced appetite, mild nausea and a low fever are common for 1 to 2 weeks, a pattern called post-embolisation syndrome, and are usually milder than after chemoembolisation. For about a week you are advised to keep close contact with small children and pregnant women brief. Blood tests are checked at 2 to 4 weeks and again with the first scan.

• Back to everyday activity: 1 to 2 weeks of fatigue
• When results show: Scan response at about 3 months
• How long they last: Months to years of control; varies widely

Safety, risks and revision policy

Most side effects are mild and short-lived, but misplaced beads or a fragile liver can cause serious harm, which is why mapping is mandatory.

• Fatigue, nausea, abdominal pain and low fever for up to 2 weeks
• Stomach or duodenal ulcer if beads reach the gut arteries
• Radiation-induced liver disease weeks later, with jaundice and fluid, in a small percentage
• Radiation pneumonitis if lung shunting was underestimated, which is rare
• Gallbladder inflammation or bile duct injury
• Bruising or bleeding at the artery puncture site
• Temporary fall in blood lymphocyte count

Every written proposal arranged through Clinic-Y states what the clinic covers if a correction is needed. Ask for it before you book, not after.

Cost of Radioembolisation (SIRT, Y-90) for Liver Tumours in Türkiye

Clinic-Y does not publish a single price for Radioembolisation (SIRT, Y-90) for Liver Tumours, because the honest figure depends on your case. What moves it:

• Type and activity of microspheres ordered, which are made to order for each patient
• One lobe or both lobes treated
• Mapping angiogram and nuclear medicine scans
• Hospital nights and post-treatment imaging
• Pre-treatment PET-CT or MRI if not already done

Send your photographs or reports and you receive written, all-inclusive proposals from suitable teams, side by side. Reviewing your case is free.

Frequently Asked Questions