Transarterial Radio-embolisation of liver tumours (TARE)

Transarterial radioembolization (TARE), also known as selective internal radiation therapy (SIRT), is a minimally invasive procedure used primarily to treat liver cancer, including both primary liver cancers (such as hepatocellular carcinoma) and metastatic liver cancers (such as those from colorectal cancer). The procedure involves the delivery of radioactive microspheres directly to the tumor through the hepatic artery.

Here’s an overview of the process and its benefits:

Procedure Overview

1. Pre-procedure Evaluation:
   • Imaging: MRI or CT scans to assess the liver and tumor.
   • Angiography: A detailed map of the blood supply to the liver is created to plan the treatment.
   • Lung Shunt Study: To measure the amount of blood flow from the liver to the lungs to ensure safe delivery of the microspheres.
2. Preparation:
   • Catheter Placement: A catheter is inserted through a small incision, usually in the groin, and guided through the arterial system to the hepatic artery supplying the tumor.
3. Delivery of Microspheres:
   • Radioactive Microspheres: Tiny beads loaded with a radioactive isotope (typically Yttrium-90) are injected through the catheter directly into the hepatic artery.
   • Targeted Delivery: The microspheres lodge in the small blood vessels surrounding the tumor, delivering high-dose radiation directly to the tumor cells while sparing most of the surrounding healthy tissue.

Benefits

• Localized Treatment: High doses of radiation are delivered directly to the tumor with minimal impact on surrounding healthy tissue.
• Minimally Invasive: Compared to traditional surgery, TARE involves less risk and shorter recovery times.
• Outpatient Procedure: Often performed on an outpatient basis, allowing patients to return home the same day.
• Combination Therapy: Can be used in conjunction with other treatments such as chemotherapy or systemic radiation therapy.

Indications

• Primary Liver Cancer: Such as hepatocellular carcinoma (HCC), especially in cases where surgery is not feasible (Click here to read more on Hepatocellular Carcinoma).
• Secondary Liver Cancer: Such as metastases from colorectal cancer or other cancers that have spread to the liver.
• Bridging Therapy: For patients awaiting liver transplantation to control tumor growth.

Risks and Considerations

• Radiation-Induced Liver Disease (RILD): A potential side effect where healthy liver tissue is damaged.
• Non-targeted Embolization: Risk of microspheres traveling to non-target areas, causing unintended damage.
• Post-embolization Syndrome: Symptoms like pain, fever, and nausea after the procedure.

Post-Procedure Care

• Monitoring: Regular follow-up imaging to assess the response to treatment.
• Symptom Management: Medications to manage pain and other side effects.
• Liver Function Tests: To monitor the impact of the treatment on liver function.

Transarterial radioembolization is a highly effective treatment option for specific types of liver cancer, offering targeted therapy with fewer side effects compared to conventional treatments. However, patient selection and careful planning are critical to its success.