Selective Internal Radiation Therapy (SIRT)

Radioembolization is a minimally-invasive procedure used to treat inoperable liver cancer. This treatment is not a cure, but can give a patient a better quality of life. The procedure benefits include:

  • Decreases tumor size
  • Causes minimally minimal side-effects
  • Fast recovery
  • The radiation use does not affect the rest of the body

Depending on the type of cancer, SIRT may also be used prior to, in conjunction with, between, or following chemotherapy

The Procedure

Not everyone with inoperable liver cancer is a candidate for this procedure. Prior to the procedure, testing will be done to determine if you are eligible.

Be sure to tell your doctor if you:

  • Have a coagulation disorder
  • Are taking medications
  • Are taking herbal supplements
  • Are allergic to
    • local anesthetics like Lidocaine, Procaine, and Benzocaine
    • general anesthesia
    • iodine
  • Are pregnant

This procedure is usually performed on an outpatient basis and takes approximately 30 to 90 minutes to complete followed by two to six hours in recovery

There are two blood supplies that feed the liver; the portal vein and the hepatic artery. The liver receives most of its blood through the portal vein and a small portion via the hepatic artery. When a tumor develops in the liver, the blood and nutrients supply supporting growth come from the hepatic artery.

Before the procedure, patients are giving medication that helps with relaxation and blocks pain. Then, using a fluoroscope as a guide, the radiologist makes an incision and inserts catheter through the groin area and guides it into the hepatic artery. Once in place, microscopic beads are introduced into the blood system. The microspheres act as an embolic agent and contain Yttrium 90 isotopes, meaning they block the food supply and deliver a dose of radiation to the tumor. By inserting the radiation via the hepatic artery, the tumor is targeted and healthy tissue in the liver is preserved.


Most patients are able to resume normal activities within a day or two. During recovery, many patients experience the following:

  • Fatigue that can last up to four weeks
  • Nausea
  • Vomiting
  • A low-grade fever
  • Loss of appetite
  • Abdominal pain

Most of these symptoms resolve themselves within three to five days. For safety reasons, the first week after treatment avoid extended or close contact with people, particularly pregnant women and children.

Patients can expect to be monitored in the following month with CT, MRI, or PET scans.