Abstract
Background: The evaluation of hepatopulmonary blood vessels with Technetium-99m macroaggregated albumin (Tc-99m MAA) scintigraphy before radioembolization with Yttrium-90 (Y-90) microspheres is a test to assess and prevent radiation pneumonitis. It was determined by the lung shunt fraction (LSF) which was calculated from a planar and SPECT/CT images. This study aimed to compare of LSF calculation from Tc-99m MAA planar and SPECT/CT images for Y-90 radioembolization treatment of liver tumors. Methods: A total of 64 patients (42 men and 22 women, mean age 64 ± 12.5 years) who underwent Tc-99m MAA scanning between 2015 and 2022 were enrolled. LSF was calculated using MIM software, where LSF from planar images was calculated as the geometric mean (GM) of the lung and liver region of interest (ROI) counts from anterior and posterior views. For SPECT/CT images, LSF was quantified from the lung and liver volumes of interest (VOI) counts, and the two LSF values were compared using paired t-test and Bland–Altman plot for statistical analysis Results: From a study of 64 patients, LSF as calculated from planar images accounted for a mean of 7.03 ± 6.57%, whereas the SPECT/CT quantitation revealed significantly lower LSF estimates at a mean of 5.29 ± 4.62% (P < 0.001). Conclusion: This study provides that LSF calculation using planar images can be significantly overestimated while calculation using SPECT/CT images and appropriate segmentation tools in MIM Encore software can be more accurate.
DOI
10.56808/2673-060X.5579
First Page
1
Last Page
14
Recommended Citation
Noipinit, Nut; Sawatnatee, Thunyaluk; Phromphao, Benchamat; Ratsameechot, Peangtawan; Thiambandit, Sutida; and Sontrapornpol, Tanawat
(2025)
"The comparison of lung shunt fraction calculation using Tc-99m MAA planar and SPECT/CT imaging for Y-90 radioembolization,"
Chulalongkorn Medical Journal: Vol. 69:
Iss.
4, Article 5.
DOI: https://doi.org/10.56808/2673-060X.5579
Available at:
https://digital.car.chula.ac.th/clmjournal/vol69/iss4/5