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Radiation Therapy · Theranostics & Radioisotope Therapy
Y-90 Radioembolisation — For Liver Tumours
Medically reviewed by Dr. Venkata Sushma P, Radiation Oncologist (MBBS · MD, Radiation Oncology) · Last reviewed August 2026
Y-90 radioembolisation sits in an awkward gap: it is a radiation treatment, but it is delivered through a catheter by an interventional radiologist working alongside nuclear medicine. That handover is why so little plain-language explanation exists. This page answers the three questions families actually ask first — how it is delivered, who is eligible, and whether it is a one-time procedure.
- The two-visit sequence, explained — the mapping angiogram first, the treatment session one to two weeks later, and why both are needed.
- Eligibility in plain terms — the liver-function tests, the lung-shunt check and the artery anatomy that decide whether it can be done at all.
- One session, not a daily course — how a lobe-by-lobe plan works, and what recovery in the first fortnight usually looks like.
- Coordinated, not outsourced — delivered at an NABH-accredited partner centre, with your CION oncology team managing the plan around it.
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The short answer
What is Y-90 radioembolisation?
Y-90 radioembolisation is a liver-directed radiation treatment. Millions of microscopic spheres carrying radioactive yttrium-90 are passed through a thin catheter into the artery feeding the tumour. They lodge in the tiny vessels around the tumour and release short-range radiation from inside the liver over the following days.
You may also see it called selective internal radiation therapy, internal radiation for the liver, or simply SIRT. All four names describe the same idea: rather than aiming a machine at the liver from outside, the radiation is carried to the tumour by the liver’s own blood supply and left there.
The reason it works this way is a quirk of liver anatomy. Healthy liver tissue draws most of its blood from the portal vein, while liver tumours draw most of theirs from the hepatic artery. Delivering the spheres into that artery therefore concentrates them in and around the tumour rather than spreading them evenly through the organ.
It belongs to the wider family of treatments explained on our theranostics and radioactive medicine page — but with one difference that matters practically. Most radioisotope treatments are given as an injection or a drip by a nuclear medicine team. This one is delivered through a catheter by an interventional radiologist, with nuclear medicine calculating and handling the dose. Two departments, one procedure. That overlap is exactly why it is so hard to find a straight patient-level account of it, and why this page exists.
Y-90 radioembolisation is delivered at an NABH-accredited partner centre; CION Cancer Clinics coordinates your treatment plan, your oncology team and your care throughout. CION does not own or operate a nuclear medicine facility, an interventional radiology suite, a linear accelerator or any other radiotherapy equipment.
Did you know?
The radiation from yttrium-90 travels only a few millimetres through tissue before it is absorbed, and half of it has decayed within about two and a half days. That is why the dose stays concentrated in the treated part of the liver — and why the precautions you go home with are much lighter than after other radioisotope treatments.
Question one
How is Y-90 radioembolisation delivered?
It is delivered in two separate hospital visits, not one. First a mapping angiogram charts the liver arteries and a radioactive test tracer checks how much would reach the lungs. One to two weeks later, an interventional radiologist passes a catheter from the wrist or groin and releases the spheres into the target artery.
Almost every family is surprised by the two-visit structure, because nothing about the name suggests it. The first visit is not treatment. It is the safety check that decides whether the second visit can happen at all, and it changes the plan often enough that no team will book the treatment before it is done.
1
Review and team decision
Your scans, liver blood tests and prior treatment history are reviewed together by medical oncology, interventional radiology and nuclear medicine. This is the point at which liver-directed treatment is compared with the other routes open to you, rather than assumed.
2
Visit one: the mapping angiogram
A fine catheter is threaded from the wrist or the groin into the liver arteries under local anaesthetic and light sedation. The arteries are mapped in detail, and any small branch that could carry spheres to the stomach or bowel is blocked off deliberately. A radioactive test tracer is then released exactly where the treatment will go.
3
The lung-shunt scan and dose planning
A scan the same day shows where that test tracer travelled — in particular, what share of it slipped through to the lungs. Nuclear medicine uses this, together with the volume of liver being treated, to calculate the dose. If too much reaches the lungs, the plan is changed or stopped here.
4
Visit two: the treatment session
One to two weeks later the same catheter route is used again, and the yttrium-90 spheres are released slowly into the artery feeding the tumour. The session itself typically takes about an hour. You are awake but sedated, and you feel the contrast rather than the radiation.
5
Confirmation scan, then home
A scan within a day confirms the spheres settled where they were aimed. Most patients are discharged the same day or the next morning, with instructions for the first fortnight and a follow-up appointment for liver blood tests and imaging.
If you are arranging this for a parent from another city, budget for two hospital visits one to two weeks apart, not one trip. Ask the partner centre for both dates in writing before you book travel.
Question two
Who is eligible for Y-90 radioembolisation?
Eligibility is decided by a combined team, not on request. It is generally considered when cancer is confined to, or mainly in, the liver — primary liver cancer or liver metastases — when liver function is preserved, when the mapping scan shows little leak to the lungs, and when the artery anatomy can be treated safely.
The single biggest misunderstanding here is that eligibility is about the cancer. It is at least as much about the liver. A liver that is already struggling cannot absorb a radiation dose and keep working, so the blood tests carry as much weight as the scan does.
What a team is usually looking for
- Disease that is confined to the liver, or where the liver is clearly the dominant problem — commonly primary liver cancer, or spread to the liver from a bowel or neuroendocrine primary.
- Preserved liver function: no jaundice, no significant fluid in the abdomen, bilirubin within the range the treating centre accepts.
- A mapping scan showing only a small share of the test tracer reaching the lungs.
- Artery anatomy that can be catheterised, with off-target branches able to be blocked off safely at the mapping visit.
- Reasonable general fitness — able to lie still for the procedure and to manage a fortnight of low-grade recovery afterwards.
- A joint decision by interventional radiology, nuclear medicine and your oncologist, taken with your latest scans in front of them.
What usually makes it unsuitable
- Significant disease outside the liver that would not be addressed by treating the liver alone.
- Decompensated liver disease — jaundice, ascites or advanced cirrhosis — where the liver has no reserve to spare.
- A large lung shunt on the mapping scan, because too much of the dose would land in the lungs.
- Artery anatomy that cannot be made safe, where spheres could not be kept away from the stomach or bowel.
- Poor general fitness, or an urgent problem such as biliary obstruction that has to be dealt with first.
Guideline bodies including NCCN and ESMO place liver-directed treatments such as this one in specific, selected settings rather than as a routine first step. It is not a replacement for surgery, for systemic treatment or for a transplant assessment where those are options for you.
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Question three
Is Y-90 radioembolisation a one-time procedure?
For the part of the liver being treated, usually yes. Most patients have one treatment session per liver territory, delivered as a day case or a single overnight stay. When both lobes are involved, treatment is often staged into two sessions a few weeks apart. Repeat treatment is possible, but it is a fresh decision.
This is the practical difference that matters most to working families. There is no daily attendance, no six-week schedule, no mask and no machine table. What there is instead is one or two carefully planned procedure days, and a recovery fortnight after each.
| Your situation | What is usually planned |
|---|---|
| Tumour confined to one lobe or one territory | One treatment session after the mapping visit, usually a day case or one overnight stay |
| Both lobes of the liver involved | Often two sessions, staged a few weeks apart, so the liver recovers between them; sometimes a single mapping visit covers both |
| New or regrown disease in a treated area later | Repeat treatment is possible in selected cases, but is reassessed from scratch — liver function and fresh imaging decide it |
| Disease appearing outside the liver afterwards | The conversation moves to systemic or other liver-directed options rather than repeating this procedure |
A staged plan is not a sign that something went wrong. Treating one lobe at a time is a deliberate way of protecting liver function, and it is planned from the start when both lobes are affected.
What recovery looks like
What are the side effects of Y-90 radioembolisation?
Most people get a cluster of effects in the first one to two weeks that teams call post-embolisation syndrome: tiredness, a low-grade temperature, nausea and a dull ache under the right ribs. Liver blood tests can shift for some weeks and are monitored. Serious complications are uncommon and are what the mapping visit exists to prevent.
| What you may notice | Why it happens | What usually helps |
|---|---|---|
| Tiredness | The commonest effect of any liver-directed treatment, usually strongest in the first week to ten days | Plan a genuinely quiet fortnight, short walks rather than bed rest, and no travel booked for the week after the session |
| Low-grade temperature | Part of post-embolisation syndrome as the treated tissue responds | Usually settles on its own within days; a temperature above the number your team gives you, or with shivering, is reported the same day |
| Dull ache under the right ribs | Swelling of the treated part of the liver inside its capsule | Pain relief as prescribed by your team; tell them before discharge if you already have abdominal pain so it is planned rather than improvised |
| Nausea and reduced appetite | A common early effect in the days after the session | Small frequent meals, plenty of fluid, and a prescribed anti-sickness medicine if your team advises one |
| Changes in liver blood tests | The treated liver tissue receives the radiation dose and takes time to settle | Routine blood tests over the following weeks; new jaundice, swelling of the abdomen or confusion is reported urgently, not at the next appointment |
| Stomach or duodenal ulcer (uncommon) | Spheres reaching a branch supplying the stomach or duodenum instead of the liver | This is precisely why off-target vessels are blocked off at the mapping visit; new burning upper abdominal pain or black stools needs same-day review |
This is what is commonly reported in NCCN and ESMO patient guidance for liver-directed treatment. It is not exhaustive — your written consent discussion at the partner centre covers the full list for your dose. Side effects across the wider radioisotope family are compared on our side effects of radioisotope therapy page.
The part families ask about most
Am I radioactive after Y-90 radioembolisation?
Barely, and only briefly. Yttrium-90 gives off radiation that travels only a few millimetres in tissue, so almost all of it stays inside the treated part of your liver. Precautions are far lighter than after iodine or lutetium treatments, and most centres discharge patients within a day with short, simple instructions.
Families who have read about other radioisotope treatments often arrive expecting a shielded room and a week of distance rules. That is not how this one works. The spheres stay lodged in the liver rather than clearing through urine, and the radiation they give off does not travel far enough to reach anyone standing next to you.
You will still be given written instructions, usually covering the first few days and often focused on the catheter site rather than on radiation. Ask the nuclear medicine team to go through that sheet with whoever will actually be at home with you, not only with the patient. If you are comparing this with the household rules after other radioisotope treatments, our pages on radium-223 for bone metastases and samarium and strontium injections for bone pain set out how those differ.
Follow the written dates on your own instruction sheet rather than a general figure from a forum. Doses, protocols and discharge rules differ between centres.
Access and coordination
How is Y-90 radioembolisation arranged in Hyderabad?
It is a specialised service, not a routine one. Your procedure is delivered at an NABH-accredited partner centre with an interventional radiology suite and a licensed nuclear medicine department, while CION Cancer Clinics coordinates your treatment plan, your oncology team and your care around it.
In practice the sequence is: a consultation and record review, cross-sectional liver imaging, a combined team decision, then the mapping visit and the treatment session one to two weeks apart. Dates depend on angiography slots and on sphere stock and ordering lead time at the partner centre, so they are confirmed rather than assumed. Ask for both in writing.
If you are coordinating from outside Hyderabad
Adult children arranging care for a parent usually want to know how much travel is unavoidable. Scans and prior records can be reviewed remotely before anyone books a ticket, so the eligibility conversation happens before the journey rather than after it. Once a plan is agreed, budget for two hospital visits one to two weeks apart, plus a recovery fortnight after the treatment session where your parent should not be travelling.
What about cost?
Radioembolisation is quoted per treatment session, and the mapping angiogram, the test tracer scan and the imaging before and after are billed separately from the treatment itself. A staged plan covering both lobes therefore costs more than a single-territory plan, so the total is a range rather than one fixed figure. Any estimate you are given is indicative, as of August 2026, and shifts with the centre, the imaging protocol and stock availability. Our page on the cost of theranostics and radioisotope therapy in India sets out what an itemised estimate should contain and what insurance and government schemes typically do and do not cover.
Ask for a written, itemised estimate naming what is included — mapping visit, scans, spheres, procedure, room, follow-up — before you commit to anything.
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Common questions
Y-90 radioembolisation — your questions answered
How is Y-90 radioembolisation delivered?
It is delivered in two separate hospital visits rather than one. At the first visit, an interventional radiologist threads a fine catheter from the wrist or the groin into the liver arteries, maps them, blocks off any small vessel that could carry spheres to the stomach or bowel, and gives a radioactive test tracer. A scan then measures how much of that tracer reached the lungs. One to two weeks later, at the second visit, the same catheter route is used to release the yttrium-90 spheres into the artery feeding the tumour. The treatment session itself usually takes about an hour, and most patients go home the same day or the next morning.
Who is eligible for Y-90 radioembolisation?
Eligibility is decided by a combined team, not on request. It is generally considered when the cancer is confined to, or mainly in, the liver, either as primary liver cancer or as liver metastases from a bowel or neuroendocrine primary. Liver function has to be preserved, so jaundice, fluid in the abdomen and advanced cirrhosis usually rule it out. The mapping scan has to show that only a small share of the test tracer reaches the lungs, and the artery anatomy has to be treatable safely. Widespread disease outside the liver, poor general fitness or a large lung shunt normally point to a different route.
Is Y-90 radioembolisation a one-time procedure?
For the part of the liver being treated, usually yes. Most patients receive one treatment session per liver territory, given as a day case or a single overnight stay, and there is no daily course to attend. When both lobes of the liver are involved, many teams stage the treatment into two sessions a few weeks apart so the liver has time to recover between them. Repeat treatment of an area is possible in selected cases, but it is a fresh team decision based on your liver function and later scans, never something planned in advance as a routine second round.
What are the side effects of Y-90 radioembolisation?
The most common is a cluster of effects in the first one to two weeks that teams call post-embolisation syndrome: tiredness, a low-grade temperature, nausea, reduced appetite and a dull ache under the right ribs. Liver blood tests can shift for some weeks afterwards and are monitored. Less commonly, spheres that reach the stomach or duodenum can cause an ulcer, which is why the mapping visit blocks off those vessels first. Rarely, a large lung shunt can affect the lungs, which is why the test tracer scan is done before treatment is confirmed.
Am I radioactive after Y-90 radioembolisation?
Barely, and only briefly. Yttrium-90 gives off radiation that travels only a few millimetres in tissue, so almost all of it stays inside the treated part of your liver rather than leaving your body. Precautions are far lighter than after iodine or lutetium treatments, and most centres discharge patients the same day or the next morning with a short list of simple instructions for a few days. Your nuclear medicine team gives you those instructions in writing with dates on them. Follow the written dates you are given rather than a general figure you read online.
What does Y-90 radioembolisation cost in India?
It is quoted per treatment session, and the mapping angiogram, the test tracer scan and the imaging before and after treatment are billed separately from the treatment itself. That means a plan covering both lobes of the liver costs more than a single-territory plan, so the total is a range rather than one fixed number. Any figure you are given is indicative, as of August 2026, and shifts with the centre, the imaging protocol and stock availability. Ask for a written, itemised estimate naming what is and is not included, and check what your insurance or scheme will cover before you commit.
This page is a general explainer about Y-90 radioembolisation, not medical advice and not a recommendation for your case. Only your treating oncology, interventional radiology and nuclear medicine team, working from your own scans and blood tests, can say whether this treatment is an option for you.