Yttrium-90 Selective Internal Radiation Therapy

Abstract

Yttrium-90 Selective internal radiation therapy is a growing part of the field of liver-directed radiation therapy. This technique involves the delivery of radioactive microbeads directly into liver tumors via the blood supply. There are presently two devices available to deliver Y90, with different techniques and clinical considerations for the two devices. This therapy requires careful work-up and appropriate patient selection that is best accomplished in the context of a multidisciplinary oncology team. This treatment has demonstrated efficacy in the treatment of colorectal metastases, hepatocellular carcinoma, neuroendocrine tumor, with emerging data in other malignancies. This chapter seeks to describe the appropriate patient selection, work-up, technique, dosimetry, complications, and follow-up of Y90 as performed in current clinical practice.