Post-mortem considerations of Yttrium-90 90Y microsphere therapy procedures

Area of Science:

• Nuclear Medicine
• Radiochemistry
• Oncology

Background:

• Yttrium-90 (Y) microspheres are used to treat unresectable hepatocellular cancer.
• Long-lived radioactive contaminants, Europium-154 (Eu) and Europium-155 (Eu), can be present in Y-90 microsphere waste.

Purpose of the Study:

• To address regulatory and safety concerns arising from long-lived contaminants in Y-90 microsphere therapy waste.
• To highlight potential risks to funeral home staff and crematorium operators.
• To improve patient and family awareness regarding potential radioactive contamination.

Main Methods:

• Investigation of an elevated count rate in a deceased patient previously treated with Y-90 microspheres.
• Assessment of regulatory implications for autopsy and cremation procedures.
• Development of a patient consent and notification form.

Main Results:

• An elevated count rate was detected in a patient nearly 5 months post-Y-90 therapy.
• While exposure rates were below regulatory concern in this case, long-lived contaminants pose risks.
• Existing patient information failed to disclose the presence of these contaminants and cremation issues.

Conclusions:

• Long-lived contaminants from Y-90 microsphere therapy require careful management.
• Enhanced patient education and consent forms are crucial.
• Further education for medical and funeral service staff, along with regulatory cooperation, is necessary for safe disposal and handling.