A Cases Series of Discrepancies in Lung Shunt Fraction Calculation Between 2D Planar and 3D Single Photon Emission Computed Tomography Imaging for Y-90 Radioembolization in Hepatocellular Carcinoma Patients with Ascites

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Paula Gamero Kubota, MD, Robert Wagner, MD, Christopher Molvar, MD, James Halama, PhD and Judy R. James, PhD

Abstract

Accurate lung shunt fraction (LSF) is essential for safe Yttrium-90 (Y-90) transarterial radioembolization (TARE) treatment of hepatocellular carcinoma (HCC) in patients with ascites. However, traditional 2D imaging might be inaccurate for LSF calculation in this population. This study compared 2D planar imaging with 3D single photon emission computed tomography (SPECT) for LSF calculation in HCC patients with ascites undergoing TARE. Significant discrepancies were found between 2D and 3D SPECT LSF measurements, suggesting potential overestimation with 2D imaging. 3D SPECT offers a more precise method for LSF calculation in HCC patients with ascites, potentially leading to safer and more effective TARE treatment with higher Y-90 doses.

Published on: August 09, 2024
doi: 10.17756/micr.2024-105

Citation:  Kubota PG, Wagner R, Molvar C, Halama J, James JR. 2024. A Cases Series of Discrepancies in Lung Shunt Fraction Calculation Between 2D Planar and 3D SPECT Imaging for Y-90 Radioembolization in Hepatocellular Carcinoma Patients with Ascites. J Med Imaging Case Rep 8(1): 18-22.

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