Selective Internal Radiation Therapy for Liver

Selective internal radiation therapy, also known as radioembolization, is a treatment for advanced liver cancer that uses microspheres to deliver radiation therapy directly to a tumor with relative sparing of neighboring healthy liver tissue.

Our team of imaging physicians, nurses and technologists who specialize in this procedure is led by our chief of Vascular and Interventional Radiology, Marc L. Friedman, MD.

How Does the Procedure Work?

A small incision is made in the patient's groin crease. Then, under X-ray guidance, a flexible catheter is manipulated by one of our subspecialized interventional radiologists into the liver artery. The microspheres are then released. The blood stream carries the microspheres directly to the tumor or tumors in the liver where they lodge in the small blood vessels feeding the tumor and deliver their dose of radiation. Compared to conventional external beam radiation therapy, this technique enables treatment with relatively high doses of radiation directly to the cancer cells. 

The procedure takes approximately one hour. It usually requires two sessions to treat the entire liver (if necessary), with the second session occurring about a month after the first session. The procedure is performed in the outpatient setting with no requirement for hospitalization. 

A catheter is precisely manipulated under X-ray guidance through blood vessels to the tumor site so that the microspheres can be delivered directly to the tumor.

Close-up view. 

Spheres being released into the blood stream from a catheter.

Images of a radioembolization of a liver tumor showing (left, yellow arrow) the tumor before treatment, and (right) 26 months post treatment. The liver is the large organ on the left side and top left side of the CT images. The liver tumors are the darker areas on the lower half of the liver (arrow at largest tumor). In the post-treatment image, the largest tumors have been completely embolized and appear black (arrow).

How Do I Learn Whether I Qualify?

You should consult your physician to find out if you are a possible candidate for internal radiation therapy. Patients may be candidates if:

  • They have inoperable cancer which has originated in or spread to the liver and is not responding to chemotherapy
  • The liver is the major site of disease
  • They meet the pre-selection criteria established by the doctor's pre-treatment assessment