Optimizing dosimetric accuracy in radioembolization: comparative effectiveness of SPECT/CT, planar imaging, and PET/CT for lung shunt fraction assessment

In radioembolization therapy for hepatic malignancies, the accurate estimation of lung shunt fraction (LSF) is crucial to minimize the risk of radiation-induced pneumonitis and fibrosis due to hepatopulmonary shunting of yttrium-90 (90Y)-microspheres. This study aimed to compare the accuracy and precision of LSF estimation using technetium-99m macroaggregated albumin single photon emission computed tomography ([99mTc]Tc-MAA SPECT) LSF, [99mTc]Tc-MAA planar LSF, and 90Y PET LSF in patients undergoing 90Y-radioembolization.