TARE / SIRT (radioembolisation with yttrium-90)
Injecting tiny radioactive glass or resin beads into the liver's artery so they lodge in the tumour and irradiate it from inside.
Overview
Yttrium-90 microspheres (20-60 µm) deliver beta radiation over a few millimetres with a 64-hour half-life, treating hepatocellular carcinoma, colorectal liver metastases and neuroendocrine liver metastases. Randomised trials against sorafenib (SARAH, SIRveNIB) showed no survival gain but better tolerability; radiation segmentectomy, which delivers ablative doses to a small segment, achieves outcomes close to ablation. Dosimetry now individualises the activity (DOSISPHERE). Chosen over TACE when portal vein thrombus is present.
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