Emory Saint Joseph's Hospital is offering a minimally invasive radio embolization treatment called the Y-90, for patients with primary or metastatic liver cancer. Interventional radiologist Charles Gilliland, MD performs the outpatient procedure, which combines embolization, in which blood vessels are blocked off to prevent blood flow, and radiation therapy.

During the minimally invasive procedure, tiny glass or resin beads filled with the radioactive isotope yttrium Y90, are injected through a catheter, traveling from the main artery to the site of the tumor.

The beads, which are less than half the width of a human hair, deliver a high dose of radiation to the tumor, once they become lodged at the tumor site. During the two weeks following the Y-90, radiation is released from the beads lodged in the blood vessels. In order to accurately ensure that the radioactive beads are only delivered into the liver, physicians study and generate a detailed map of the blood vessels before the procedure.

"Many cancers are what we call hyperemic, which means that they want a lot of blood flow. The cancer needs blood to survive, so it grows a lot of blood vessels in order to feed it, and we use this against the tumor. The more blood flow the tumor gets, more radioactive microspheres get deposited into the tumor," says Gilliland.

Radio embolization can potentially offer higher doses of radiation, rather than having to pass through other overlying tissue, because radioactive material is placed directly inside a patient’s body. During standard radiation therapy, high-energy X-ray beams generated by a machine are directed at the tumor from outside the body.

The Y-90 is a palliative option for patients who are not candidates for other treatments such as surgery, or for those patients who have previously completed chemotherapy and radiation therapy.