Interventional procedure overview of selective internal radiation therapy for neuroendocrine tumours that have metastasised to the liver
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What the procedure involves
In SIRT, microspheres containing radioactive beta-nucleotides (90Y, 166Ho) are infused through the hepatic artery and carried by blood flow to the vessels that supply the tumour. Infusion through this route minimises damage to healthy liver tissues because they are mainly supplied by the portal vein, whereas the tumours are mainly supplied by hepatic arteries.
The procedure is done in 2 stages. First, the work-up is done to assess blood supply to the tumour, assess lung shunt, exclude extrahepatic uptake and plan personalised dosimetry. Then during SIRT, the microspheres containing the radionuclide are infused through a catheter placed in the hepatic artery. Catheterisation is done under local anaesthetic.
The procedure is done in specialist centres. Suitability of SIRT is discussed by a multidisciplinary team experienced in interventional and vascular radiology and nuclear medicine. It takes 1 to 2 hours to complete.
It may be possible to cure the cancer with SIRT, but expert feedback indicated that the main purposes of SIRT are to enable further treatment if SIRT successfully reduces tumour size, slows tumour growth or controls the symptoms of carcinoid syndrome.
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