Research ArticleBasic Science Investigation

Indirect Lung Absorbed Dose Verification by 90Y PET/CT and Complete Lung Protection by Hepatic Vein Balloon Occlusion: Proof of Concept

Yung Hsiang Kao, Calvin Gan, Alicia Corlett, Alexander Rhodes, Dinesh Sivaratnam and Beng Ghee Lim
Journal of Nuclear Medicine Technology September 2022, 50 (3) 240-243; DOI: https://doi.org/10.2967/jnmt.121.263422

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  • FIGURE 1.
    FIGURE 1.

    (A) CT coronal view shows a large inoperable hepatocellular carcinoma. (B) Planar liver–lung imaging showed a high lung shunt fraction of 26% estimated by 99mTc-MAA. (C) Fluoroscopy of right and middle hepatic vein balloon occlusion depicts contrast injection within the middle hepatic vein to visually confirm complete occlusion. (D) Fluoroscopy of hepatic vein occlusion balloons in their final inflated positions prior to radiomicrosphere infusion.

  • FIGURE 2.
    FIGURE 2.

    (A) Bremsstrahlung planar scintigraphy does not show any visually significant lung activity, a qualitative indication of successful lung protection. (B) 90Y PET/CT with PET isocontour threshold 2% to encompass all activity within planning target volumes. Lungs were outside the PET field of view. Left liver lobe was spared from radioembolization. (C) 90Y PET/CT of delivery apparatus with PET isocontour threshold 1% to encompass all residual activity. (D) 90Y PET/CT with PET isocontour threshold 7% to quantify tumor activity.

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