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Radioembolisation (SIRT / Y-90) - targeted liver radiation, delivered through the artery.

Yttrium-90 microspheres - TheraSphere glass or SIR-Spheres resin - infused through the hepatic artery to lodge in tumour capillaries and treat liver cancer from the inside out. Interventional oncology MDT, MAA mapping first, delivery in a specialist centre.

See indicative pricing
A radiographer guides a patient onto the bed of an advanced 3 Tesla MRI scanner in a London imaging suite

Indicative pricing

What private Y-90 radioembolisation costs in the UK.

Indicative ranges across our partner interventional oncology centres.

In short

£15,000–£25,000, home day-case or one night.

Procedure Indicative range
Interventional oncology consultation £350–£550
Workup angiogram with Tc-99m MAA mapping £3,500–£6,000
Y-90 resin (SIR-Spheres) unilobar delivery £15,000–£22,000
Y-90 glass (TheraSphere) unilobar delivery £17,000–£25,000
Bilobar Y-90 delivery (staged) £24,000–£30,000
Radiation lobectomy planning package £18,000–£26,000
Follow-up MRI liver with contrast £650–£950

Prices vary by centre, by microsphere product (TheraSphere glass sits at the top of the range), by whether treatment is unilobar or staged bilobar, and by whether radiation lobectomy planning is included. The workup angiogram with MAA mapping is always a separate first visit.

The problem

The right patient, the right dose, and the MDT that got there properly.

Radioembolisation is where liver-directed oncology quietly under-delivers - patient selection short-circuited, lung shunt not respected, and the MDT never actually convened. We fix all three before you consent.

  • Is SIRT actually the right tool?

    For some patients TACE, ablation, resection or systemic therapy is a better first move. We ask that question before recommending Y-90.

  • Lung shunt is not a formality

    MAA mapping and coil-embolisation of extrahepatic vessels must be done, and the numbers must be respected. Shortcut here and you get radiation pneumonitis or ulceration.

  • A real interventional oncology MDT, not a single operator

    Hepatology, medical oncology, nuclear medicine and hepatobiliary surgery in the room. Otherwise transplant, resection and salvage options get quietly closed off.

When it helps

When radioembolisation is the right step.

The scenarios we see most, plus the one red flag that means same-day hepatology and interventional oncology rather than a routine appointment.

  • Hepatocellular carcinoma (BCLC B)

    Intermediate-stage HCC not amenable to resection, ablation or transplant - where SIRT is a well-evidenced alternative to TACE, particularly for larger or infiltrative tumours.

  • Colorectal liver metastases

    Chemo-refractory or oligometastatic liver-dominant disease from colorectal primary, where systemic options are exhausted or need a liver-focused adjunct.

  • Bridge to transplant

    Y-90 to control HCC within Milan or UCSF criteria while a patient waits for a liver transplant, keeping disease from progressing off-list.

  • Downstaging for resection

    Selective or lobar Y-90 to shrink a tumour enough to bring it back within resectable or transplantable criteria.

  • Salvage after TACE or ablation

    Recurrent or persistent disease after previous transarterial chemoembolisation, microwave or radiofrequency ablation - where the arterial territory still allows delivery.

  • Neuroendocrine liver metastases

    Liver-dominant NET metastases, particularly grade 1–2, where somatostatin analogues and PRRT alone are not controlling hepatic disease.

  • Radiation lobectomy for hypertrophy

    High-dose lobar Y-90 that both treats tumour and induces contralateral lobe hypertrophy - an alternative to portal vein embolisation before major hepatectomy.

  • Red flag: hepatic decompensation

    New ascites, jaundice, encephalopathy or rapidly climbing bilirubin after any liver-directed therapy is not a routine call - same-day hepatology and interventional oncology, not a follow-up slot.

Procedure options

Product, target and dose all depend on the tumour.

What each option involves - product (TheraSphere glass vs SIR-Spheres resin), target (lobar, segmental, whole-liver) and intent (palliative, downstaging, ablative or lobectomy).

  • TheraSphere (Y-90 glass)

    Non-biodegradable glass microspheres, higher activity per sphere and lower particle number - favoured for radiation segmentectomy and lobectomy where high localised dose is the goal.

  • SIR-Spheres (Y-90 resin)

    Biocompatible resin microspheres, higher particle number and more embolic effect - often used for colorectal liver metastases and diffuse HCC.

  • Lobar delivery

    Y-90 delivered to the right or left hepatic artery - the standard approach for larger or multifocal tumours confined to one lobe. Recovery is usually a day-case.

  • Whole-liver (staged bilobar)

    Both lobes treated in two sessions four to six weeks apart. Reserved for bilobar disease with preserved liver function and no significant lung shunt.

  • Radiation segmentectomy

    A very high dose delivered to a single hepatic segment - behaves ablatively for solitary HCC up to about 5 cm and can substitute for surgical resection in selected patients.

  • Radiation lobectomy

    Ablative-intent lobar Y-90 that both treats tumour and induces future liver remnant hypertrophy - an alternative to portal vein embolisation before hemihepatectomy.

  • Combined with systemic therapy

    Sequenced with immunotherapy or tyrosine kinase inhibitors in HCC, or with FOLFOX-based regimens in colorectal metastases, under joint IR–oncology governance.

  • SIRT versus TACE

    SIRT offers a longer treatment interval, better outpatient tolerability and stronger evidence in large or portal-vein-invasive HCC; TACE remains cheaper, faster to arrange and effective for smaller nodular disease.

Safety and recovery

What to expect afterwards - honestly.

Y-90 is well established. The things worth planning are patient selection, dosimetry, and - for anyone with borderline liver reserve - the plan if bilirubin starts to drift after treatment.

  • Two visits, both under local

    Neither the workup angiogram nor the Y-90 delivery needs a general anaesthetic. Femoral or radial arterial access under local, conscious sedation as needed.

  • Lung shunt fraction is the gate

    MAA mapping measures how much activity would reach the lungs. A shunt above 20 percent - or an absolute lung dose above thresholds - puts Y-90 off the table, or forces a dose reduction.

  • Post-embolisation syndrome

    Fatigue, low-grade fever, right upper quadrant discomfort and nausea for one to three weeks. Usually managed at home with simple analgesia and antiemetics - a call, not a return visit.

  • REILD (radioembolisation-induced liver disease)

    A veno-occlusive-type liver injury, most often four to eight weeks after treatment - jaundice, ascites, rising bilirubin. Rare with good selection; the reason Child-Pugh B7 and above is generally excluded.

  • Gastroduodenal ulceration

    If any Y-90 refluxes into the gastroduodenal or right gastric artery. Prevented by careful pre-treatment angiography and coil embolisation of extrahepatic vessels during the workup.

  • Radiation pneumonitis and cholecystitis

    Uncommon when lung shunt and cystic artery are respected. Steroid-responsive pneumonitis if it occurs; symptomatic cholecystitis very occasionally needs cholecystectomy.

  • Contraindications we screen for

    Child-Pugh C, bilirubin above 2 mg/dL without a reversible obstructive cause, uncontrolled extrahepatic disease that would not be palliated, and lung shunt fractions that cannot be dose-mitigated.

  • HRT, chemo and immunotherapy timing

    Systemic therapy is usually paused around each Y-90 session - the exact window depends on the agent. Your medical oncologist agrees the schedule before booking.

  • Red flags after treatment

    New jaundice, worsening ascites, confusion, persistent severe pain, black stools or breathlessness need the same-day team or A&E - not a routine call.

Reading your treatment note

Your Y-90 note in four parts. Read the last one first.

Whether the delivery used TheraSphere or SIR-Spheres, and whether the target was a segment, a lobe or both lobes, the note the interventional radiologist sends you keeps to the same shape.

A UK consultant interventional radiologist reviewing a patient’s Y-90 treatment notes

A quiet reminder

Dosimetry language is precise and can read coldly - we translate it for you.

If you would like us to talk you through the delivery note and the 3-month response scan before your review, just ask.

  1. 01 Header

    Indication, target and product

    Why SIRT was chosen, which lobe or segments were treated, and whether TheraSphere glass or SIR-Spheres resin was used.

  2. 02 Technique

    Access, angiographic anatomy and dose

    Femoral or radial access, hepatic arterial anatomy, any extrahepatic vessels coil-embolised, calculated activity delivered and the dosimetry model used (MIRD or partition).

  3. 03 Findings

    Distribution and lung shunt

    Bremsstrahlung SPECT or Y-90 PET-CT confirmation of intrahepatic distribution and lung dose, cross-referenced with the pre-treatment MAA study.

  4. 04 Impression

    Next steps and monitoring plan

    Read this first: expected recovery, bilirubin and LFT monitoring schedule, MRI response assessment window and the downstream question - resection, transplant listing or further treatment.

Recognised by major UK insurers

BupaAXA HealthVitalityAvivaWPACignaHealixBupaAXA HealthVitalityAvivaWPACignaHealixBupaAXA HealthVitalityAvivaWPACignaHealix

Y-90 radioembolisation is usually covered when medically indicated and the MDT has documented that no better first-line option exists.

Frequently asked

Everything we get asked about radioembolisation.

Quick answers on TheraSphere vs SIR-Spheres, cirrhosis, curative intent, cost, NHS access and combining Y-90 with systemic therapy.

  • What actually is radioembolisation, and how is it different from chemoembolisation?

    Radioembolisation - also called SIRT, or Y-90 - delivers tiny radioactive microspheres through the hepatic artery to lodge in the tumour capillaries, where they emit beta radiation over about two weeks. TACE, by contrast, delivers chemotherapy plus an embolic agent through the same route. SIRT is less embolic, better tolerated as an outpatient, and often preferred for larger tumours, portal vein invasion and multifocal disease.

  • What is the workup angiogram and why do I need it?

    It is a mandatory first visit, one to two weeks before delivery. The interventional radiologist maps your hepatic arterial anatomy, coil-embolises any small vessels that could carry Y-90 to the stomach or duodenum, and injects Tc-99m MAA - a surrogate for Y-90 - to measure how much would shunt to the lungs. Without this mapping, Y-90 cannot be given safely.

  • Can I have SIRT if I have cirrhosis?

    Cirrhosis is not a barrier in itself - most HCC patients treated with Y-90 have cirrhosis. What matters is liver function reserve. Child-Pugh A and well-selected B7 patients are usually eligible; Child-Pugh C, bilirubin above 2 mg/dL without a reversible cause, or clinically significant portal hypertension shift the risk of REILD too high to justify treatment.

  • Is SIRT curative, or a life-extending treatment?

    It depends on the setting. Radiation segmentectomy for a solitary HCC up to about 5 cm can be ablative and is considered a curative-intent option. Radiation lobectomy can bridge or downstage a patient to resection or transplant, which is potentially curative. In the palliative setting - chemo-refractory colorectal mets or advanced HCC - the goal is disease control and life extension, not cure.

  • How much does Y-90 cost privately in the UK?

    Roughly £15,000–£22,000 for a unilobar SIR-Spheres delivery and £17,000–£25,000 for TheraSphere, plus £3,500–£6,000 for the workup angiogram and MAA mapping. Staged bilobar treatment runs £24,000–£30,000.

  • Is Y-90 available on the NHS?

    Yes, for defined indications. NHS England commissions SIRT for chemo-refractory colorectal liver metastases and, more recently, for selected HCC, delivered through a small number of specialist tertiary centres. Access via the NHS depends on MDT referral and commissioning criteria; private routes offer more flexibility on timing and centre choice.

  • How long is recovery, and when will I know if it worked?

    Most people are back to light activity in a few days, with fatigue and mild right-sided discomfort lasting one to three weeks - the post-embolisation syndrome. Response is assessed by MRI liver with hepatobiliary contrast at 3 months, sometimes sooner if radiation segmentectomy was ablative in intent. Full radiological effect takes up to 6 months.

  • Can I have SIRT alongside immunotherapy or chemotherapy?

    Yes, and it is increasingly the norm. In HCC, Y-90 is sequenced with atezolizumab–bevacizumab or tyrosine kinase inhibitors under joint governance. In colorectal metastases, it is often combined with FOLFOX-based regimens. Systemic therapy is usually paused for a defined window around each Y-90 session - your medical oncologist agrees the exact schedule before booking.

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