Once it has been decided that a patient is suitable for SIRT, arrangements are made for two procedures.
SIRT 1 (preparation of the liver for SIRT 2)
The first SIRT procedure is to prepare the liver for insertion of the SIR-spheres (microscopic radiotherapy beads) which takes place during SIRT procedure 2. This involves a short inpatient stay at The Christie Clinic, with blood tests and a trip to the radiology department. Patients often only need to be admitted for one night. The procedure takes place in the interventional radiology suite and involves insertion of a catheter (tube) into the groin which is fed into the liver via the hepatic artery.
Contrast agents (liquids which show up clearly on scans) are injected into the liver via the catheter and multiple x-rays are taken. The contrast agents allow the consultants to see the blood vessels in the liver, where the SIR-spheres are to be placed, and check there will be no problems with the treatment. The radiologist inserts small coils into certain blood vessels to block them off, ensuring that, when it comes to SIRT 2, the radiation beads cannot exit the liver. The patient has another scan after this procedure to double check the area. Patients are normally kept in until the next day and then discharged.
SIRT 2 (insertion of the SIR-sphere microscopic radiation beads)
The second SIRT procedure takes place approximately 2 weeks after SIRT 1. This usually involves admission to The Christie Clinic for at least one night. Patients often have chemotherapy around the time of this procedure, and may already be receiving chemotherapy as an inpatient.
The patient is taken to the interventional radiology suite. The liver blood vessels were prepared in the first procedure and, once again, a catheter is introduced into the hepatic artery via the groin. The SIR-spheres are injected into the catheter via a syringe. The patient stays with us overnight and a repeat scan usually takes place the day after the procedure. If the team is happy that the SIR-spheres are in place and there are no problems, then the patient may be discharged, dependent on their treatment programme, returning for a follow up appointment about two weeks after the procedure.