Radioembolization Therapy

What Is Radioembolization Treatment?

Radioembolization treatment is an interventional treatment method that delivers radiation directly to liver tumors using radioactive microspheres. The treatment generally uses microspheres containing a radioactive substance called Y-90. These microspheres are delivered into the blood vessels feeding the tumor with the help of a catheter.

This allows a high proportion of the radiation to be delivered directly to the tumor tissue. The aim is to minimize the effect on healthy liver tissue. Radioembolization may be used particularly for certain primary and metastatic tumors located in the liver. The procedure does not require open surgery. Suitability for treatment is determined according to the extent of the tumor and liver function. The patient’s general health condition is also included in the evaluation.

How Is Radioembolization Treatment Performed?

Radioembolization treatment is performed by delivering radioactive microspheres into the liver vessels feeding the tumor through a catheter advanced inside the blood vessel. A preparation angiography is generally performed before treatment. This procedure provides a detailed map of the liver vessels. Certain vessels may be closed for safety purposes. The risk of the radioactive material passing into the lungs is also evaluated.

On the day of treatment, the catheter is usually advanced through a blood vessel in the groin or wrist. The catheter is directed to the target liver vessel. Y-90-containing microspheres are then administered in a controlled manner. The microspheres settle in the small vessels around the tumor. From there, they emit radiation over a limited distance and target the tumor cells.

For Which Diseases Is Radioembolization Treatment Used?

Radioembolization treatment may be used particularly for primary liver cancers and certain metastatic cancers that have spread to the liver. Hepatocellular carcinoma is one of its important areas of use. It may also be considered for certain liver tumors originating from the bile ducts. Liver metastases from colorectal cancer may be treated in selected patients. The method may also be used for liver metastases from neuroendocrine tumors.

The main areas of use include:

• Hepatocellular carcinoma.
• Intrahepatic cholangiocarcinoma.
• Colorectal cancer liver metastases.
• Neuroendocrine tumor metastases.
• Selected other liver metastases.

Not every liver tumor is suitable for radioembolization. The treatment decision is individualized according to the extent of the disease.

Who Is a Candidate for Radioembolization Treatment?

Radioembolization treatment may be performed in selected patients who have suitable liver tumors and adequate liver function. The method may be considered in patients who are not suitable for surgical treatment. In some patients, it may be used to shrink the tumor in preparation for subsequent treatments. Before treatment, the liver vessels and the blood supply of the tumor are examined in detail.

The following factors are important in patient selection:

• The number and size of tumors.
• The distribution of tumors within the liver.
• The condition of liver function.
• The extent of disease outside the liver.
• Suitability of the vascular anatomy.
• The patient’s general health condition.

Suitability may be evaluated by interventional radiology, nuclear medicine, and oncology teams.

How Do You Prepare for Radioembolization Treatment?

Before radioembolization treatment, blood tests, imaging studies, and preparation angiography are performed to evaluate the safety of the treatment. Blood tests may be requested to assess liver and kidney function. Coagulation values are also checked. The medications used by the patient are reviewed in detail. Special planning may be required for blood-thinning medications.

The following procedures may be performed during preparation:

• MRI or computed tomography.
• Angiography of the liver vessels.
• Y-90 dose calculation.
• Evaluation of the lung shunt fraction.
• Blood and coagulation tests.
• Assessment of contrast agent allergy.

Medications should not be stopped without a doctor’s recommendation. Fasting for a certain period may be required before the procedure.

How Long Does Radioembolization Treatment Take?

Radioembolization treatment usually takes one to two hours, although the total duration may vary depending on vascular anatomy. Preparation angiography and treatment are generally performed on different days. In both procedures, a catheter must be advanced through a blood vessel. Complex vascular anatomy may extend the procedure time.

Administration of Y-90 microspheres is only one part of the procedure. Catheter placement and control imaging are also included in the duration. The patient may be kept under observation after the procedure is completed. Therefore, the total time spent in the hospital may last several hours. Some patients may require overnight observation. The exact duration is determined according to the scope of the treatment.

What Are the Advantages of the Treatment?

The main advantage of radioembolization is that it aims to deliver a high dose of radiation directly to the liver tumor while protecting healthy tissue. The treatment is administered through a blood vessel and does not require a large surgical incision. This feature may help shorten the recovery period. It may provide a local treatment option for some patients who are not suitable for surgery.

The advantages of radioembolization treatment include:

• It is performed in a minimally invasive manner.
• Tumor tissue can be targeted directly.
• Healthy liver tissue may be affected less.
• It does not require a large surgical incision.
• It may shrink the tumor in some patients.
• It can be planned together with other treatments.
• Hospital stay may be short.

The benefit obtained varies according to the characteristics of the disease.

What Are the Risks and Side Effects?

Fatigue, abdominal pain, nausea, and temporary changes in liver function may occur with radioembolization treatment. The procedure is generally performed in a controlled manner. However, as with every interventional treatment, there is a risk of complications. One of the important risks is the radioactive microspheres reaching areas outside the target region.

Possible side effects include:

• Weakness and fatigue.
• Abdominal pain.
• Nausea and loss of appetite.
• Mild fever.
• Bleeding at the vascular access site.
• Deterioration in liver function.
• Damage to the stomach or intestines.
• Rarely, severe liver damage.

The healthcare team should be contacted if severe pain, high fever, or jaundice develops.

What Is the Recovery Process After Radioembolization Treatment?

After radioembolization treatment, most patients can return to a significant portion of their daily activities within a few days.

Fatigue and mild abdominal pain may occur during the first few days. Some patients may experience decreased appetite or low-grade fever. These symptoms generally decrease over time.

It is important to keep the vascular access site clean. Strenuous exercise and heavy lifting may be limited during the first few days. Medications prescribed by the doctor should be used as recommended.

The effect of the treatment is not evaluated immediately. Follow-up MRI or computed tomography examinations are performed on scheduled dates. Medical attention should be sought if severe pain, jaundice, or high fever develops.

Radioembolization Treatment Prices 2026

Radioembolization treatment prices in Turkey in 2026 range from approximately 180,000 TL to 350,000 TL.

The total cost may vary depending on the amount of Y-90 microspheres used and the hospital’s pricing policy. Preparation angiography is also an important procedure that affects the total cost. Treatment of both liver lobes may require an additional session.

The main factors affecting the price include:

• The cost of Y-90 microspheres.
• The amount of microspheres used.
• Preparation angiography.
• Dosimetry and nuclear medicine services.
• Catheter and angiography materials.
• Length of hospital stay.
• Follow-up imaging.

When obtaining the final price, it should be asked whether all services are included in the package.

Frequently Asked Questions

For which types of cancer is radioembolization treatment used?

Radioembolization treatment may be used for liver cancers and selected cancer types that have metastasized to the liver. Hepatocellular carcinoma is one of the important areas of use for this method. It may also be considered in some patients with intrahepatic cholangiocarcinoma. It may be one of the treatment options for liver metastases from colorectal cancer.

Radioembolization may also be used for liver metastases from neuroendocrine tumors. Selected patients with liver metastases from breast cancer or other tumors may also be evaluated. Whether the treatment can be performed does not depend only on the type of cancer. The tumor burden in the liver and vascular anatomy are also important. An individualized decision is made by evaluating liver function and previous treatments.

How many times can radioembolization treatment be performed?

Radioembolization treatment may be performed more than once when necessary, but the number of sessions is determined according to the patient’s liver function. The right and left lobes of the liver may be treated in separate sessions in some patients. Therefore, even the initial treatment may require more than one procedure. In repeated treatments, the remaining healthy liver tissue is carefully evaluated.

The effect of previous radioembolization treatment is monitored with imaging methods. Tumor response and the patient’s general condition are important when deciding on a new session. There is no fixed maximum number that applies to every patient. Repeat treatment may not be appropriate when the risk of liver damage increases. The decision is made by a multidisciplinary healthcare team.

How many days do patients stay in the hospital after radioembolization?

After radioembolization, many patients can be discharged from the hospital on the same day or after one night of observation. The length of hospital stay varies according to the patient’s general condition and the scope of the treatment performed. The absence of bleeding at the vascular access site is important for discharge. Control of pain and nausea is also evaluated.

People with additional health problems may require longer observation. If a serious complication develops after the procedure, the hospital stay may be extended. Vital signs and general condition are checked before discharge. The patient’s ability to move safely is also evaluated. The healthcare team performing the treatment determines the exact length of hospitalization.

What should be considered after radioembolization?

After radioembolization, attention should be paid to rest, care of the vascular access site, and the radiation safety recommendations provided by the healthcare team. Strenuous exercise and heavy lifting may be limited during the first few days. Mild bruising may occur at the vascular access site. Recommendations regarding dressing care should be followed.

Patients should watch for the following symptoms:

• Severe or increasing abdominal pain.
• High fever.
• Jaundice.
• Persistent vomiting.
• Heavy bleeding at the vascular access site.
• Significant shortness of breath.

Medications should be taken as recommended by the doctor. Follow-up blood tests and imaging should not be missed. Individual radiation safety instructions should be followed for the specified period.

Does radioembolization treatment completely destroy the tumor?

Radioembolization may cause the tumor to completely lose its viability in some patients, but a definitive result cannot be guaranteed in every patient. Treatment success depends on the size and extent of the tumor. Liver function may also affect treatment response. A complete response may be seen in some tumors. In others, shrinkage or slowing of disease progression may be achieved.

The effect of treatment is evaluated with follow-up imaging. MRI or computed tomography may be used for this purpose. If viable tumor tissue remains, additional treatments may be considered. The possibility of developing new tumors is not completely eliminated after radioembolization. Therefore, regular oncological follow-up is important.

What is the difference between radioembolization and chemoembolization?

Radioembolization uses microspheres that carry radiation, while chemoembolization delivers chemotherapy medication and vessel-blocking materials to the tumor. Both treatments can be administered through the liver vessels with the help of a catheter. However, their main mechanisms of action on the tumor are different. In radioembolization, radiation provides the main therapeutic effect. In chemoembolization, chemotherapy and vessel blockage are used together.

The treatment choice is made according to the individual patient.