Selective internal radiation therapy for non-resectable colorectal metastases in the liver

NICE interventional procedures guidance [IPG401] Published date:

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The National Institute for Health and Clinical Excellence (NICE) has issued full guidance to the NHS in England, Wales, Scotland and Northern Ireland on Selective internal radiation therapy for non-resectable colorectal metastases in the liver.

It replaces the previous guidance on Selective internal radiation therapy for colorectal metastases in the liver (Interventional Procedures Guidance no.93  September 2004).

  • Description

    Colorectal liver metastasis is cancer that has spread to the liver from the bowel. Selective internal radiation therapy (known as SIRT) uses radiation put into the patient’s liver to kill the cancer cells. Tiny radioactive ‘beads’ are injected into the artery that supplies blood to the liver (the hepatic artery). The beads become trapped (embolise) in the tiny blood vessels surrounding the cancer, releasing radiation directly onto it.

  • OPCS4.6 Code(s)

    J12.3 Selective internal radiotherapy with microspheres to lesion of liver

    X65.3 Delivery of a fraction of interstitial radiotherapy

    Y36.4 Introduction of non-removable radioactive substance into organ for brachytherapy NOC

    Y89.- Brachytherapy (where necessary)

    Y53.4 Approach to organ under fluoroscopic control

     In addition the ICD-10 code C78.7 Secondary malignant neoplasm of liver and intrahepatic bile duct and a code from category C18.- Malignant neoplasm of colon would be recorded.

    The NHS Classifications Service of the Health and Social Care Information Centre is the central definitive source for clinical coding guidance and determines the coding standards associated with the classifications (OPCS-4 and ICD-10) to be used across the NHS.  The NHS Classifications Service and NICE work collaboratively to ensure the most appropriate classification codes are provided.  http://systems.hscic.gov.uk/data/clinicalcoding

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