Medical Oncologist
CION Cancer Clinics
Who is suitable for Y-90 radioembolisation? | CION Cancer Clinics
Y-90 is usually considered for liver cancer that cannot be removed or ablated, is mostly confined to the liver, and sits in a liver that still works reasonably well. A mapping scan must also show the beads can be placed safely. This page explains what the team weighs, when Y-90 is chosen over TACE or surgery, and who it does not suit. At CION Cancer Clinics, a multidisciplinary tumour board weighs your liver function and your scans before recommending any treatment.
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Medically reviewed by Dr. Naresh GunduConsultant Medical Oncologist · MBBS, DNB (Internal Medicine), DM (Medical Oncology, AIIMS) · last reviewed October 2026, next review due October 2027
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The short answer
Who is Y-90 radioembolisation usually meant for?
Y-90 is usually considered for people whose cancer started in the liver itself, cannot be removed or burned away, and is mostly confined to the liver. It also needs a liver that is still working reasonably well. Those two conditions decide most of the answer.
Y-90, also called TARE or radioembolisation, places tiny radioactive beads into the arteries that feed a liver tumour. The radiation works from inside the tumour and spares much of the healthy liver. The technique itself is explained on our Y-90 radioembolisation page. This page is about the decision: who is a good candidate, and who is not.
Primary or secondary: which one is yours?
Most of this page is about hepatocellular carcinoma (HCC), the most common cancer that starts in the liver. Y-90 is also used for some cancers that spread to the liver from the bowel or elsewhere, but the reasoning is different. If your cancer began somewhere else, read Y-90 for liver metastases instead.
Suitability is decided by a tumour board after scans and a mapping test. No single report settles it on its own.What the team weighs
What decides whether Y-90 is right for you?
Doctors look at four things together: the tumour, the liver around it, the person and the blood vessels.
The tumour
Y-90 suits tumours that are too large or too many for ablation, or sit where surgery is not possible. It can also treat a single large tumour in one part of the liver very precisely.
Often considered when
- The cancer is mostly within the liver
- One large tumour or a cluster in one area
- Tumour has grown into a branch of the portal vein
The liver around it
Radiation affects healthy liver too. A liver already struggling with cirrhosis may not cope. Teams look at bilirubin (the yellow pigment that causes jaundice), albumin (a protein the liver makes) and the Child-Pugh score, which grades how well the liver is working.
The person
You need to be well enough to be up and about for most of the day, and to lie still through a procedure done through a small tube in the groin or wrist.
The blood vessels
The beads must travel only where they are meant to go. The mapping scan checks this, and some people are ruled out by what it shows.
Not sure whether this applies to you?
Ask an oncologistHow the decision is made
What happens before anyone says yes to Y-90?
Scans and blood tests
A recent triple-phase CT or MRI shows the size and spread of the tumour. Blood tests show how well the liver is working. CION arranges these through its diagnostic partners if they are not already done.
The tumour board
Medical oncologists, surgeons, interventional radiologists and hepatologists review your case together. They compare Y-90 with surgery, ablation, TACE and medicines before recommending one.
The mapping scan
If Y-90 looks right, a rehearsal angiogram is done first. It maps the arteries and checks how much would leak to the lungs or gut. Read why the mapping scan is needed.
The final yes or no
Only after mapping does the team confirm the plan. Y-90 is coordinated through accredited partner hospitals with nuclear medicine and interventional radiology. Your team will tell you where it takes place.
Side by side
When is Y-90 chosen over other liver treatments?
Y-90 tends to be favoured
Another option tends to be favoured
Tumour has grown into a branch of the portal vein
TACE is usually avoided here, so it is less often chosen
One large tumour on one side of the liver
Surgery is favoured if the tumour can be safely removed
Fewer hospital visits matter to you
TACE is often repeated over several sessions
A bridge while waiting for surgery or transplant
Ablation is favoured for a single small tumour
Cancer is mostly inside the liver
Medicines are favoured when it has spread outside the liver
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Being honest
Who is Y-90 not suitable for?
Y-90 is not suitable for everyone, and hearing that is not a failure. It usually means another treatment is safer or more likely to help.
When the liver is too weak
If you have jaundice, a lot of fluid in the abdomen (ascites), or advanced cirrhosis, the radiation can tip the liver into failure. Most teams will not offer Y-90 to people with Child-Pugh C liver function. Some people with milder Child-Pugh B may still be considered with great care.
When the cancer has spread widely
Y-90 treats only the liver. If cancer has reached the lungs, bones or lymph nodes outside the liver, medicines such as atezolizumab plus bevacizumab usually come first.
When the mapping scan rules it out
If too much of the dose would travel to the lungs, or blood flows to the stomach or bowel in a way that cannot be blocked, Y-90 is unsafe. See lung shunting for what this means.
When surgery or ablation can remove it
A small tumour that can be removed or burned away is usually treated that way, because those options aim to remove the cancer completely.
What we cannot say here
What this page cannot tell you
It cannot tell you whether you personally are suitable. That depends on your scans, your blood results, the mapping scan and a discussion between several specialists who have seen all of it. Two people with the same stage on paper can get different advice for good reasons.
It cannot predict how well Y-90 will work for you
Results depend on the tumour, the liver and what else is planned alongside. Nobody can honestly give you a figure for your own outcome from a web page, and you should be wary of anyone who does.
It cannot tell you about cost or access
Y-90 is offered at a limited number of centres in India, and the beads are costly. Ask for a written, itemised estimate once a plan is agreed. The cost and availability pages in this section explain what goes into it.
If you have recent scans and a liver function report, CION can arrange a tumour board review and tell you honestly whether Y-90 is worth exploring.Questions we are asked
Common questions about who can have Y-90
Can I have Y-90 if I have cirrhosis?
Often yes, if the cirrhosis is mild and the liver is still working well. Most people with liver cancer in India have some cirrhosis, so it does not rule Y-90 out by itself. What matters is how much reserve the liver has, which the team judges from blood tests and the Child-Pugh score.
Is Y-90 used when TACE has stopped working?
Sometimes. If TACE no longer controls the tumour and the cancer is still mostly in the liver, Y-90 may be discussed. More often, the team moves to medicines at that point. The choice depends on how much the liver has been affected by earlier treatment.
Can Y-90 be given if the portal vein is blocked by tumour?
This is one of the situations where Y-90 is often considered, because the beads do not block the artery the way TACE does. It is still a careful decision based on liver function and how far the tumour has grown. The page on Y-90 with portal vein thrombosis explains this in more detail.
Am I too old for Y-90?
Age alone does not usually rule it out. Doctors look at how active you are, how well your liver and kidneys work, and any heart or lung problems. Many older people who are independent day to day are assessed for it in the same way as younger patients.
Does Y-90 work for bile duct cancer inside the liver?
It is sometimes used for intrahepatic cholangiocarcinoma that cannot be removed, but the evidence is thinner than for HCC. These tumours should also have their DNA tested, because some have targeted options. Ask your oncologist how the choices compare in your case.
Can Y-90 be combined with immunotherapy or tablets?
This is being studied, and some teams do use Y-90 alongside medicines for selected patients. The evidence is still developing. Your medical oncologist will explain whether combining them makes sense for you, or whether one should come first.
Why did the mapping scan rule me out?
Usually because too much blood flowed from the liver to the lungs, or vessels carried flow towards the stomach or bowel that could not be safely blocked. Either would put radiation where it could cause harm. Your team will discuss what alternatives remain, which often include TACE or medicines.
How do I find out if I am suitable?
Gather your latest CT or MRI, the report, and recent liver blood tests. Ask for a tumour board review. Call the CION helpline, and someone will arrange a consultation with a medical oncologist who can take your case to the board.
Your Specialists
Meet CION's liver cancer specialists. Bring your scan reports and liver blood tests.
Our medical and surgical oncologists plan liver cancer care together, weighing the tumour and how well your liver works before choosing surgery, a liver-directed procedure or medicines.
Medical Oncologist
Dr. C. Raghavendra Reddy
MBBS(Gold Medal), DNB(General Medicine), DM(Medical Oncology)(Gold Medal)
Medical Oncologist
Dr. Bharati Devi Gorantla
MBBS, MD(General Medicine), DM(Medical Oncology)(Adyar,Chennai), ECMO, MRCP SCE(UK)
Medical Oncologist
Dr. Owais Mohammed
MBBS, MD (General Medicine), DrNB (Medical Oncology), ECMO, MRCP SCE (Medical Oncology) (UK)
Medical Oncologist
Medical Oncologist
Surgical Oncologist
Dr. Muralidhar Muddusetty
MBBS (AIIMS), MS (Surgery) (AIIMS), DNB (Surgical Oncology), MRCS (Edinburgh)
Surgical Oncologist
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Sources
- RadiologyInfo.org (RSNA/ACR) — Radioembolization (Y90)
- American Cancer Society — Embolization Therapy for Liver Cancer
- EASL — EASL Clinical Practice Guidelines: management of hepatocellular carcinoma
- National Cancer Institute — Liver Cancer Treatment
This page is general information, not a prescription. Do not change or stop any treatment based on what you read here. If anything is worrying you, contact your own treating team — or call our helpline and we will help you reach the right specialist.
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Related pages
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Wondering whether Y-90 is an option for you?
Send us your recent scans and liver blood tests, and a CION medical oncologist can take your case to the tumour board. We will tell you honestly whether Y-90 or another treatment fits better. One helpline serves every CION centre.