Radioembolisation

Hepatic radioembolisation is a curative or palliative medical treatment used to treat certain liver tumours, such as hepatocellular carcinoma (HCC) or liver metastases from other cancers. This procedure combines interventional radiology and internal radiotherapy to directly target cancer cells in the liver.

Benefits

  • Precise targeting: administration of radioactive microspheres by selective catheterisation directly into the hepatic arterial network.
  • Localised treatment: Action directly on the tumour without significantly affecting the surrounding healthy tissue. 
  • Tumour reduction: Emission of radiation damaging the tumour cells with reduction in size or destruction. 
  • Option for patients who are not candidates for surgery: Some patients are not candidates for surgery because of their overall state of health or the location of the tumour. 
  • Combined treatment: Possible combination with chemotherapy or external radiotherapy.
  • Less invasive procedure: Compared with certain surgical procedures, hepatic radioembolisation is considered a less invasive procedure.

Treatments 

Hepatic radioembolisation is a medical procedure that involves administering radioactive microspheres directly into the blood vessels supplying the tumour lesion.

The following are the general steps in the liver radioembolisation procedure:

  • Patient assessment: Patients are carefully assessed to determine whether they are suitable to receive treatment for hepatic radioembolisation. Imaging tests such as computed tomography (CT) or magnetic resonance imaging (MRI) are used to assess the size, location and nature of the liver tumour.
  • Preparation: Before the procedure, a blood test is carried out to assess the patient's liver function.
  • Catheterisation: The interventional radiologist places a femoral catheter in a hepatic artery. The catheter is guided to the blood vessels supplying the tumour.
  • Administration of microspheres: Radioactive microspheres are injected into the blood vessels leading to the tumour. These microspheres, loaded with Yttrium-90, emit radiation to destroy the tumour.

Post-treatment

After the procedure, the patient is monitored for 4-6 hours to detect any adverse effects or complications.

Patients may experience side effects such as fatigue, mild abdominal pain, nausea or fever for a few days after the procedure. These symptoms are generally temporary and can be managed with medication.

Subsequent imaging tests, such as PET/CT or MRI, may be carried out to assess the effectiveness of the treatment by observing the reduction in tumour size.

It is important to note that hepatic radioembolisation is a specialised procedure that requires thorough assessment and medical expertise. The benefits and risks must be carefully discussed between the patient and the medical team before any decision is taken.

Frequently Asked Questions

What is liver radioembolisation?

Liver radioembolisation, also known as selective internal radiotherapy, is a medical procedure used to treat certain liver tumours and liver metastases from other cancers. This technique combines radiotherapy and embolisation to target tumour cells in the liver more specifically.

What are the risks of radioembolisation?

As with any medical procedure, there may be reactions to the procedure itself, such as bleeding, infection or allergic reactions to the products used during the procedure. In addition, hepatic complications may rarely occur, such as worsening of liver failure in patients whose liver function is already compromised.

How does radioembolisation work?

After the interventional radiologist has inserted a hepatic arterial catheter, the nuclear physician injects radioactive beads to destroy the tumour.

Who carries out radioembolisation?

The nuclear physician in conjunction with the interventional radiologist.

When should radioembolisation be carried out?

The decision to carry out liver radioembolisation depends on a number of factors, including the type of liver tumour, its stage, the patient's general state of health and other medical considerations. The indication should be discussed for each patient at the oncology consultation and multidisciplinary meeting.

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