Y90 Radioembolization

In Y90 radioembolization, a radioactive substance called yttrium-90 (Y90) is loaded onto microscopic particles of glass or plastic resin. These particles are injected into the blood vessels that feed the tumor.

The particles enter the tumor, delivering high doses of radiation from the inside. Normal, healthy tissue receives only very small amounts of radiation.

What diseases does Y90 radioembolization treat?

Y90 radioembolization is used to treat liver tumors. This includes hepatocellular carcinoma, the most common type of liver cancer. Y90 radioembolization allows doctors to treat the cancer without removing large portions of the liver. Depending on the patient, treating hepatocellular carcinoma with Y90 radioembolization can:

• help cure the disease.
• help slow or stop the cancer’s progress and relieve symptoms.
• shrink and kill the tumors enough that the patient qualifies for a liver transplant or other surgery.

Y90 radioembolization is also a treatment for other cancers that have metastasized, or spread, to the liver, including but not limited to cholangiocarcinoma, colorectal cancer, melanoma and neuroendocrine tumors. When cancer spreads, it may form several metastatic tumors in a short period of time. Because of this, the treatment is usually not able to cure the disease. Instead, it helps slow or stop the cancer’s progress and relieve symptoms.  

Who gets Y90 radioembolization?

Y90 radioembolization is typically offered to patients who are not healthy enough for surgery or whose tumors cannot be removed with surgery due to their size, location or the number of tumors. It is often used to treat people who have too many tumors to undergo similar treatments, like cryoablation, microwave ablation and radiofrequency ablation.

What happens during a Y90 radioembolization procedure?

Y90 radioembolization treatment has two phases.

The first is mapping, which is used to identify the blood vessels that feed the tumor. This starts with an imaging exam called an angiogram.

During this procedure, doctors send a small tube, called a catheter, into a blood vessel in the groin or wrist. They steer the catheter through the body and into the liver. Vessels that feed the tumor are identified. Nearby blood vessels that don’t feed the tumor may be blocked with tiny coils to stop the Y90 from entering healthy tissue.

The patient is then injected with a harmless radioactive material that can be tracked in the body. Doctors use this step to calculate how powerful the Y90 treatment should be.

Mapping lasts about two hours.

The second phase is the treatment itself. It usually takes place a few days after mapping and takes about one hour.

During treatment, the patient undergoes another angiogram. The radioactive particles are then injected into the vessels feeding the tumor. The particles enter the tumor and kill cancer cells with radiation from the inside. Damage to nearby healthy tissue is limited.

Patients are typically released from the hospital on the day of their procedure. They are usually walking in a few days and fully recovered in two to three weeks.

Y90 radioembolization side effects

Side effects for Y90 radioembolization are generally mild and easy to manage. They include:

• fatigue
• nausea
• vomiting
• gastrointestinal ulcers.  

In rare cases treatment can cause more serious side effects, such as infection and injury to the bile ducts. These may require a tube to drain the ducts.

Y90 radioembolization at MD Anderson

Choosing where to go for cancer care is one of the most important decisions you can make. At MD Anderson, patients are treated by a team of doctors that usually includes a medical oncologist, surgeon, radiation oncologist and interventional radiologist. They work together to design a personalized treatment plan tailored to each patient.

If the team recommends Y90 radioembolization, you’ll get care from leaders in the field. Our doctors are among the most experienced in the world at Y90 radioembolization treatment. This gives them incredible experience and expertise when designing each treatment. As members of a top-ranked cancer center, they have access to the most advanced technologies, allowing them to deliver the most effective treatment while minimizing side effects.

And at MD Anderson you will be surrounded by the strength of one of the nation's largest and most experienced cancer centers. From support groups to counseling to integrative medicine care, we have all the services needed to treat not just the disease, but the whole person.