HCC Radioembolization with Yttrium-90 Polymer Beads (SIR-Spheres)

Introduction: Transarterial radioembolization (TARE) is a form of brachytherapy in which microspheres loaded with the radioactive isotope yttrium-90 (90Y) are injected selectively to the tumor-feeding arteries through a catheter using fluoroscopic guidance. The use of 90Y microspheres leads to tumor necrosis by delivering a high radiation dose (>70 Gy, tumoricidal threshold) directly to HCC nodules, sparing the non-tumoral liver, and with little or no embolic effect on the vessels. Resin 90Y microspheres are 20–60 μm in size, carry approximately 50 Bq/sphere, and contain 40–80 million microspheres per 3 GBq (1 vial).