Selective internal radiotherapy (SIRT), is an established treatment for unresectable
hepatocellular carcinoma (HCC) and liver metastases. A catheter guides the 90Y microspheres
into the liver where they deliver a high absorbed dose, typically 150Gy, to the tumour.
99mTc- macroaggregated albumin (99mTc-MAA) particles, which mimic the distribution
of the mircospheres, are used to evaluate the lung shunt fraction (LSF) prior to treatment.
The manufacturer recommends the LSF is estimated using the geometric mean of the liver
and lung counts in anterior and posterior 99mTc-MAA planar images. This dosimetry
method has its drawbacks as scatter or attenuation effects are not accounted for.
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