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Fig. 4 | BMC Gastroenterology

Fig. 4

From: Additional hepatic 166Ho-radioembolization in patients with neuroendocrine tumours treated with 177Lu-DOTATATE; a single center, interventional, non-randomized, non-comparative, open label, phase II study (HEPAR PLUS trial)

Fig. 4

Example of lung shunt fraction overestimation by 99mTc-MAA. A patient with multiple liver metastases of a cholangiocarcinoma treated in the prior HEPAR 2 trial. Note the (visual) significant overestimation of 99mTc-MAA on planar imaging compared to the 166Ho-scout dose and 166Ho-treatment dose. Quantification of the lung shunt fraction on planar and SPECT/CT imaging confirmed the visual assessment: a 99mTc-planar = 13.4%, d 99mTc-SPECT = 6%, all 166Ho imaging modalities (b, c, e and f) with the scout dose and with the treatment dose showed a lung shunt fraction of < 1%

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