Procedures

Selective internal radiation therapy (SIRT)

Massachusetts General Hospital Imaging provides selective internal radiation therapy (SIRT), a minimally invasive, image-guided treatment for liver cancer tumors, in a caring environment using the latest technology.

Massachusetts General Hospital Imaging provides selective internal radiation therapy (SIRT), a minimally invasive, image-guided treatment for liver cancer tumors, on the Mass General main campus in Boston. Performed by specially trained radiologists using real-time image guidance, interventional-radiology procedures such as SIRT often require smaller incisions, have fewer risks of complication, and take less recovery time than traditional surgery.

SIRT overview

  • Treats malignant lesions in the liver.
  • Through very small catheters a specially trained physician will deliver tiny beads carrying radioactive material directly to the tumor using image guidance.
  • Optimizes the ability to shrink or eradicate tumors by targeting them precisely.
  • Requires only a small incision in the groin area.
  • Most often, the procedure takes approximately two hours, but requires an overnight stay for observation.
  • As a minimally invasive procedure, involves a smaller incision, fewer risks of complication, and less recovery time than traditional surgery.
  • We pay special attention to minimizing radiation exposure—without giving up image quality.
  • Our state-of-the-art imaging technology plays a key role in planning and performing each procedure, and on-staff physicists and engineers ensure that our machines remain in top condition.

SIRT in depth

What is SIRT?

SIRT is an image-guided, non-surgical procedure that is used to treat malignant lesions in the liver. The procedure uses a catheter to deliver tiny radioactive beads into the blood vessels that lead directly to the tumor. This allows doctors to treat tumors that are not accessible using conventional surgery or radiation treatments.

Specialty expertise

The interventional radiologists who perform procedures at Mass General Imaging are specialists in the area of the body and the condition under treatment, as well as the procedure itself. In addition to the training that all radiologists receive, these specialists have additional education, plus extensive real-world experience. In many cases, our doctors helped to pioneer many of the interventional treatments that we offer.

Coordinated care

Our team of interventional radiologists and nurse practitioners coordinates a patient's complete care—from imaging evaluation to post-procedure followu—maintaining a high level of communication with the patient throughout the process. In addition, Mass General Imaging works in close coordination with experts from across Mass General when necessary.

What should I expect BEFORE SIRT?

  • Pre-admission testing: We will schedule an appointment for you. Because your procedure uses contrast, we need to know whether you are allergic to any contrast. We may also draw blood to check various other readings.
  • Food and drink: You must not eat solid foods, candy, gum, or drink liquids after midnight on the night before the procedure. Your procedure may be canceled if you do.
  • Medications: It is important to tell us the names of any medications you are taking in advance of your procedure. You may need to stop taking certain medications. In addition, you may be prescribed medication for you to take a few days before the procedure.
  • When to arrive: Arrival time varies according to procedure. You will be notified when your appointment is made.
  • Preparation: A nurse will insert an intravenous (IV) line to give you sedation medications to make you more comfortable during the procedure. You will also be attached to a cardiac monitor, given a catheter to collect your urine, and connected to a blood pressure monitor. The incision area in the groin will be cleaned and shaved, and you will receive medication to numb the area.

What should I expect DURING SIRT?

During the procedure, a specially trained interventional radiologist uses live imaging to thread a plastic tube, called a catheter, through your blood vessels from a small incision in the groin to the liver. The doctor then uses the catheter to deliver the radioactive beads.

What should I expect AFTER SIRT?

You will be admitted to the hospital overnight so that we can monitor your condition. Once you return home, you should take it easy for a few days and avoid any strenuous activity for 10 days. Most people return to a normal level of activity in one to three weeks.

Imaging technology enables non-surgical treatments

Department of Radiology Chairman Emeritus James H. Thrall, MD, explains how the ability to see deep inside the body has driven the development of minimally invasive methods of treatment—a trend in which Mass General Imaging has played a key role.

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