Post-Mortem Considerations of Yttrium-90 (90Y) Microsphere Therapy Procedures

Abstract

Yttrium-90 (Y) microspheres, either in the form of resin beads or glass, are currently used to treat unresectable hepatocellular cancer. It has been discovered that long-lived contaminants, principally Eu and Eu, can be found in the waste generated by this procedure. Recently, at our medical facility, an elevated count rate was discovered on a deceased patient scheduled to have an autopsy and who had undergone Y microsphere therapy nearly 5 months previously. Regulatory issues arose when the family of the patient requested that the body of the deceased be cremated. In this particular instance the exposure rate from the body was below regulatory concern; however, the potential contamination and exposure from these long-lived contaminants cannot be ignored for individuals working in the autopsy room, funeral home embalming area, and crematorium. Information provided to potential patients in pamphlet form from the manufacturer failed to identify the existence of long-lived contaminants and possible difficulties associated with cremation. To ensure potential Y microsphere patients and family members are aware of the possible existence of long-lived contaminants, a patient consent and notification form has been developed. The proper disposal of residual material associated with these procedures, i.e., long-lived radioactive contaminants in explanted organs, pose additional difficulties. Further education of medical staff and funeral home directors with crematoriums is necessary. Close cooperation with the regulatory authority was instrumental in resolving this situation.