Optimising Dosimetric Techniques using Planar 99mTc- MAA Imaging for Selective Internal Radiotherapy

      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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