62 - Outpatient-Based Lab Yttrium-90 Radioembolization: Enhancing Efficiency and Patient Value

Purpose: While common interventional radiology (IR) procedures performed in outpatient-based lab (OBL) settings are known to reduce patient wait times, expedite discharge, and provide greater economic advantages compared to in-hospital settings {1}, Y90 radioembolization is inherently more complex due to requirements for 99mTc-MAA imaging and radiation safety. We hypothesized that performing Y90 radioembolization in an OBL setting would nevertheless improve operational efficiency and patient-centered outcomes compared to traditional in-hospital approaches, despite these additional complexities.

Materials and Methods: We performed a retrospective analysis of patients who underwent Y90 radioembolization for hepatic malignancies at our institution between January 20, 2015, and August 5, 2025. In March 2019, our institution transitioned Y90 mapping and administration from an in-hospital setting to an OBL, creating two cohorts with otherwise equivalent institutional resources. Key metrics included pre-procedure wait time, post-procedure discharge time, and total facility time. Statistical comparisons utilized the Mann-Whitney U test; significance was defined as p< 0.05.

Results: A total of 870 patients were included: 479 in the OBL group and 391 in the in-hospital group. Median wait time was significantly shorter in the OBL group (103.95 minutes) versus the in-hospital group (151.28 minutes, p< 0.05). Median post-procedure discharge time was also reduced in the OBL group (100.0 minutes) compared to the in-hospital group (181.8 minutes, p< 0.05). Overall facility time was reduced by 36.05% in the OBL cohort (p< 0.05).

Conclusion: OBL-based Y90 radioembolization is associated with significantly shorter wait times and expedited discharge relative to the in-hospital setting, despite procedural complexity. These findings support broader adoption of OBL protocols for eligible patients to enhance efficiency and patient value. Prospective, multicenter studies are warranted to corroborate these benefits and evaluate long-term clinical outcomes.