Therasphere is a Yttrium 90 microsphere that emits beta rays with a half life of about 64 hours.

High energy rays have high penetration in the body tissues. Penetration can be about 11 mm

These do not get absorbed in the body fluids.

1. Glass microspheres (Therasphere)

Both are about 25-35 mm in diameter

Total dose of radiation is about 2GBq

This leads to a high dose of radiation to the tumor only with less chances of radiation hepatitis.

Role of external beam radiotherapy in liver tumors is minimal because liver is a sensitive organ and can not withstand radiotherapy over 40 GY. Radiation induced Liver Injury (RILD) is a condition with ascites, anicteric hepatomegaly and elevated liver enzymes.

Minimally invasive intra-arterial devices that deliver high doses of radiation internally to the tumor have emerged that use radioactive yttrium-90 microspheres to deliver high tumoricidal doses while limiting the development of RILD

Embolic particles are loaded with radionuclide containing the pure beta emitter, yttrium 90. The microspheres lodge in malignant microvasculature, delivering high doses of ionizing radiation to the tumor compartment while maintaining low radiation exposure of the normal liver.

Hepato pulmonary shunting

Inability to get access

Compromised pulmonary function,

Inadequate liver reserve,

Serum creatinine more than 2.0 mg/dL

Platelet count less than 75 × 109/L

Post embolic syndrome (tiedness fatigue, pain)

Cholecystitis

Gastric Ulcer

Gastroduodenitis

Pancreatitis

Lymphopenia

51%  percent of lesions show greater than 50% reduction in tumor size.

79%  of patients will have  a tumor response when percent reduction or tumor necrosis was used as a measure of response.