Sub-lesional dosimetry - Kao et al. State-of-the-art yttrium-90 selective internal radiation therapy: Technical aspects of artery-specific SPECT/CT partition model dosimetry. J Nucl Med. 2011; 52 (Supplement 1):1084.

1. State-of-the-art yttrium-90 selective internal radiation therapy: Technical aspects of artery-specific SPECT/CT partition model dosimetry Yung Hsiang KAO (1), Andrew EH TAN (1), Richard HG LO (2), Kiang Hiong TAY (2), Mark C BURGMANS (2), Farah G IRANI (2), Li Ser KHOO (2), Bien Soo TAN (2), Pierce KH CHOW (3, 4), David CE NG (1), Anthony SW GOH (1) (1) Department of Nuclear Medicine and PET, Singapore General Hospital (2) Department of Diagnostic Radiology, Singapore General Hospital (3) Department of General Surgery, Singapore General Hospital (4) Duke-NUS Graduate Medical School, Singapore First author contact: Dr Yung Hsiang KAO MBBS, MRCP(UK), FAMS(Nuclear Medicine) [email_address] Supplemental Figure 3 : Worked example of sub-lesional dosimetry by artery-specific SPECT/CT partition modeling © Department of Nuclear Medicine and PET Dr Yung H Kao, Email: yung.h.kao@gmail.com November 2011 J Nucl Med. 2011; 52 (Supplement 1):1084

2. State-of-the-art yttrium-90 selective internal radiation therapy: Technical aspects of artery-specific SPECT/CT partition model dosimetry Note: This PDF file is best viewed in ‘ full screen’ mode i.e. ‘Ctrl+L’. © Department of Nuclear Medicine and PET Dr Yung H Kao, Email: yung.h.kao@gmail.com J Nucl Med. 2011; 52 (Supplement 1):1084

3. Figure orientation: Hepatic angiography Right Hepatic artery Left Hepatic artery Digital subtraction angiogram of celiac axis Digital subtraction angiogram of right hepatic artery Digital subtraction angiogram of left hepatic artery Catheter-directed CT hepatic angiogram of right hepatic artery Catheter-directed CT hepatic angiogram of left hepatic artery Kao et al. State-of-the-art yttrium-90 selective internal radiation therapy: Technical aspects of artery-specific SPECT/CT partition model dosimetry. J Nucl Med. 2011; 52 (Supplement 1):1084. Supplemental Figure 3 : Worked example of sub-lesional dosimetry by artery-specific SPECT/CT partition modeling.

4. Arterial territory of left hepatic artery State-of-the-art yttrium-90 selective internal radiation therapy: Technical aspects of artery-specific SPECT/CT partition model dosimetry Part of tumor supplied by right hepatic artery Figure orientation: Tc-99m-MAA SPECT/CT © Department of Nuclear Medicine and PET Dr Yung H Kao, Email: yung.h.kao@gmail.com Arterial territory of right hepatic artery Part of tumor supplied by left hepatic artery J Nucl Med. 2011; 52 (Supplement 1):1084

5. Catheter-directed CT hepatic angiogram (Right hepatic artery) Catheter-directed CT hepatic angiogram (Left hepatic artery) Tc-99m-macroaggregated albumin SPECT/CT Kao et al. State-of-the-art yttrium-90 selective internal radiation therapy: Technical aspects of artery-specific SPECT/CT partition model dosimetry. J Nucl Med. 2011; 52 (Supplement 1):1084. Supplemental Figure 3 : Worked example of sub-lesional dosimetry by artery-specific SPECT/CT partition modeling © Department of Nuclear Medicine and PET Dr Yung H Kao, Email: yung.h.kao@gmail.com

6. Catheter-directed CT hepatic angiogram (Right hepatic artery) Catheter-directed CT hepatic angiogram (Left hepatic artery) Tc-99m-macroaggregated albumin SPECT/CT © Department of Nuclear Medicine and PET Dr Yung H Kao, Email: yung.h.kao@gmail.com Kao et al. State-of-the-art yttrium-90 selective internal radiation therapy: Technical aspects of artery-specific SPECT/CT partition model dosimetry. J Nucl Med. 2011; 52 (Supplement 1):1084. Supplemental Figure 3 : Worked example of sub-lesional dosimetry by artery-specific SPECT/CT partition modeling

7. Catheter-directed CT hepatic angiogram (Right hepatic artery) Catheter-directed CT hepatic angiogram (Left hepatic artery) Tc-99m-macroaggregated albumin SPECT/CT © Department of Nuclear Medicine and PET Dr Yung H Kao, Email: yung.h.kao@gmail.com Kao et al. State-of-the-art yttrium-90 selective internal radiation therapy: Technical aspects of artery-specific SPECT/CT partition model dosimetry. J Nucl Med. 2011; 52 (Supplement 1):1084. Supplemental Figure 3 : Worked example of sub-lesional dosimetry by artery-specific SPECT/CT partition modeling

8. Tc-99m-macroaggregated albumin SPECT/CT Catheter-directed CT hepatic angiogram (Right hepatic artery) Catheter-directed CT hepatic angiogram (Left hepatic artery) © Department of Nuclear Medicine and PET Dr Yung H Kao, Email: yung.h.kao@gmail.com Kao et al. State-of-the-art yttrium-90 selective internal radiation therapy: Technical aspects of artery-specific SPECT/CT partition model dosimetry. J Nucl Med. 2011; 52 (Supplement 1):1084. Supplemental Figure 3 : Worked example of sub-lesional dosimetry by artery-specific SPECT/CT partition modeling

9. Catheter-directed CT hepatic angiogram (Right hepatic artery) Catheter-directed CT hepatic angiogram (Left hepatic artery) Tc-99m-macroaggregated albumin SPECT/CT © Department of Nuclear Medicine and PET Dr Yung H Kao, Email: yung.h.kao@gmail.com Kao et al. State-of-the-art yttrium-90 selective internal radiation therapy: Technical aspects of artery-specific SPECT/CT partition model dosimetry. J Nucl Med. 2011; 52 (Supplement 1):1084. Supplemental Figure 3 : Worked example of sub-lesional dosimetry by artery-specific SPECT/CT partition modeling

10. Catheter-directed CT hepatic angiogram (Right hepatic artery) Catheter-directed CT hepatic angiogram (Left hepatic artery) Tc-99m-macroaggregated albumin SPECT/CT © Department of Nuclear Medicine and PET Dr Yung H Kao, Email: yung.h.kao@gmail.com Kao et al. State-of-the-art yttrium-90 selective internal radiation therapy: Technical aspects of artery-specific SPECT/CT partition model dosimetry. J Nucl Med. 2011; 52 (Supplement 1):1084. Supplemental Figure 3 : Worked example of sub-lesional dosimetry by artery-specific SPECT/CT partition modeling

11. Catheter-directed CT hepatic angiogram (Right hepatic artery) Catheter-directed CT hepatic angiogram (Left hepatic artery) Tc-99m-macroaggregated albumin SPECT/CT © Department of Nuclear Medicine and PET Dr Yung H Kao, Email: yung.h.kao@gmail.com Kao et al. State-of-the-art yttrium-90 selective internal radiation therapy: Technical aspects of artery-specific SPECT/CT partition model dosimetry. J Nucl Med. 2011; 52 (Supplement 1):1084. Supplemental Figure 3 : Worked example of sub-lesional dosimetry by artery-specific SPECT/CT partition modeling

12. Catheter-directed CT hepatic angiogram (Right hepatic artery) Catheter-directed CT hepatic angiogram (Left hepatic artery) Tc-99m-macroaggregated albumin SPECT/CT © Department of Nuclear Medicine and PET Dr Yung H Kao, Email: yung.h.kao@gmail.com Kao et al. State-of-the-art yttrium-90 selective internal radiation therapy: Technical aspects of artery-specific SPECT/CT partition model dosimetry. J Nucl Med. 2011; 52 (Supplement 1):1084. Supplemental Figure 3 : Worked example of sub-lesional dosimetry by artery-specific SPECT/CT partition modeling

13. Catheter-directed CT hepatic angiogram (Right hepatic artery) Catheter-directed CT hepatic angiogram (Left hepatic artery) Tc-99m-macroaggregated albumin SPECT/CT © Department of Nuclear Medicine and PET Dr Yung H Kao, Email: yung.h.kao@gmail.com Kao et al. State-of-the-art yttrium-90 selective internal radiation therapy: Technical aspects of artery-specific SPECT/CT partition model dosimetry. J Nucl Med. 2011; 52 (Supplement 1):1084. Supplemental Figure 3 : Worked example of sub-lesional dosimetry by artery-specific SPECT/CT partition modeling

14. Catheter-directed CT hepatic angiogram (Right hepatic artery) Catheter-directed CT hepatic angiogram (Left hepatic artery) Tc-99m-macroaggregated albumin SPECT/CT © Department of Nuclear Medicine and PET Dr Yung H Kao, Email: yung.h.kao@gmail.com Kao et al. State-of-the-art yttrium-90 selective internal radiation therapy: Technical aspects of artery-specific SPECT/CT partition model dosimetry. J Nucl Med. 2011; 52 (Supplement 1):1084. Supplemental Figure 3 : Worked example of sub-lesional dosimetry by artery-specific SPECT/CT partition modeling

15. Catheter-directed CT hepatic angiogram (Right hepatic artery) Catheter-directed CT hepatic angiogram (Left hepatic artery) Tc-99m-macroaggregated albumin SPECT/CT © Department of Nuclear Medicine and PET Dr Yung H Kao, Email: yung.h.kao@gmail.com Kao et al. State-of-the-art yttrium-90 selective internal radiation therapy: Technical aspects of artery-specific SPECT/CT partition model dosimetry. J Nucl Med. 2011; 52 (Supplement 1):1084. Supplemental Figure 3 : Worked example of sub-lesional dosimetry by artery-specific SPECT/CT partition modeling

16. Catheter-directed CT hepatic angiogram (Right hepatic artery) Catheter-directed CT hepatic angiogram (Left hepatic artery) Tc-99m-macroaggregated albumin SPECT/CT © Department of Nuclear Medicine and PET Dr Yung H Kao, Email: yung.h.kao@gmail.com Kao et al. State-of-the-art yttrium-90 selective internal radiation therapy: Technical aspects of artery-specific SPECT/CT partition model dosimetry. J Nucl Med. 2011; 52 (Supplement 1):1084. Supplemental Figure 3 : Worked example of sub-lesional dosimetry by artery-specific SPECT/CT partition modeling

17. Catheter-directed CT hepatic angiogram (Right hepatic artery) Catheter-directed CT hepatic angiogram (Left hepatic artery) Tc-99m-macroaggregated albumin SPECT/CT © Department of Nuclear Medicine and PET Dr Yung H Kao, Email: yung.h.kao@gmail.com Kao et al. State-of-the-art yttrium-90 selective internal radiation therapy: Technical aspects of artery-specific SPECT/CT partition model dosimetry. J Nucl Med. 2011; 52 (Supplement 1):1084. Supplemental Figure 3 : Worked example of sub-lesional dosimetry by artery-specific SPECT/CT partition modeling

18. Catheter-directed CT hepatic angiogram (Right hepatic artery) Catheter-directed CT hepatic angiogram (Left hepatic artery) Tc-99m-macroaggregated albumin SPECT/CT © Department of Nuclear Medicine and PET Dr Yung H Kao, Email: yung.h.kao@gmail.com Kao et al. State-of-the-art yttrium-90 selective internal radiation therapy: Technical aspects of artery-specific SPECT/CT partition model dosimetry. J Nucl Med. 2011; 52 (Supplement 1):1084. Supplemental Figure 3 : Worked example of sub-lesional dosimetry by artery-specific SPECT/CT partition modeling

19. Catheter-directed CT hepatic angiogram (Right hepatic artery) Catheter-directed CT hepatic angiogram (Left hepatic artery) Tc-99m-macroaggregated albumin SPECT/CT © Department of Nuclear Medicine and PET Dr Yung H Kao, Email: yung.h.kao@gmail.com Kao et al. State-of-the-art yttrium-90 selective internal radiation therapy: Technical aspects of artery-specific SPECT/CT partition model dosimetry. J Nucl Med. 2011; 52 (Supplement 1):1084. Supplemental Figure 3 : Worked example of sub-lesional dosimetry by artery-specific SPECT/CT partition modeling

20. Catheter-directed CT hepatic angiogram (Right hepatic artery) Catheter-directed CT hepatic angiogram (Left hepatic artery) Tc-99m-macroaggregated albumin SPECT/CT © Department of Nuclear Medicine and PET Dr Yung H Kao, Email: yung.h.kao@gmail.com Kao et al. State-of-the-art yttrium-90 selective internal radiation therapy: Technical aspects of artery-specific SPECT/CT partition model dosimetry. J Nucl Med. 2011; 52 (Supplement 1):1084. Supplemental Figure 3 : Worked example of sub-lesional dosimetry by artery-specific SPECT/CT partition modeling

21. Catheter-directed CT hepatic angiogram (Right hepatic artery) Catheter-directed CT hepatic angiogram (Left hepatic artery) Tc-99m-macroaggregated albumin SPECT/CT © Department of Nuclear Medicine and PET Dr Yung H Kao, Email: yung.h.kao@gmail.com Kao et al. State-of-the-art yttrium-90 selective internal radiation therapy: Technical aspects of artery-specific SPECT/CT partition model dosimetry. J Nucl Med. 2011; 52 (Supplement 1):1084. Supplemental Figure 3 : Worked example of sub-lesional dosimetry by artery-specific SPECT/CT partition modeling

22. Catheter-directed CT hepatic angiogram (Right hepatic artery) Catheter-directed CT hepatic angiogram (Left hepatic artery) Tc-99m-macroaggregated albumin SPECT/CT © Department of Nuclear Medicine and PET Dr Yung H Kao, Email: yung.h.kao@gmail.com Kao et al. State-of-the-art yttrium-90 selective internal radiation therapy: Technical aspects of artery-specific SPECT/CT partition model dosimetry. J Nucl Med. 2011; 52 (Supplement 1):1084. Supplemental Figure 3 : Worked example of sub-lesional dosimetry by artery-specific SPECT/CT partition modeling

23. Catheter-directed CT hepatic angiogram (Right hepatic artery) Catheter-directed CT hepatic angiogram (Left hepatic artery) Tc-99m-macroaggregated albumin SPECT/CT © Department of Nuclear Medicine and PET Dr Yung H Kao, Email: yung.h.kao@gmail.com Kao et al. State-of-the-art yttrium-90 selective internal radiation therapy: Technical aspects of artery-specific SPECT/CT partition model dosimetry. J Nucl Med. 2011; 52 (Supplement 1):1084. Supplemental Figure 3 : Worked example of sub-lesional dosimetry by artery-specific SPECT/CT partition modeling

24. Catheter-directed CT hepatic angiogram (Right hepatic artery) Catheter-directed CT hepatic angiogram (Left hepatic artery) Tc-99m-macroaggregated albumin SPECT/CT © Department of Nuclear Medicine and PET Dr Yung H Kao, Email: yung.h.kao@gmail.com Kao et al. State-of-the-art yttrium-90 selective internal radiation therapy: Technical aspects of artery-specific SPECT/CT partition model dosimetry. J Nucl Med. 2011; 52 (Supplement 1):1084. Supplemental Figure 3 : Worked example of sub-lesional dosimetry by artery-specific SPECT/CT partition modeling

25. Catheter-directed CT hepatic angiogram (Right hepatic artery) Catheter-directed CT hepatic angiogram (Left hepatic artery) Tc-99m-macroaggregated albumin SPECT/CT © Department of Nuclear Medicine and PET Dr Yung H Kao, Email: yung.h.kao@gmail.com Kao et al. State-of-the-art yttrium-90 selective internal radiation therapy: Technical aspects of artery-specific SPECT/CT partition model dosimetry. J Nucl Med. 2011; 52 (Supplement 1):1084. Supplemental Figure 3 : Worked example of sub-lesional dosimetry by artery-specific SPECT/CT partition modeling

26. Catheter-directed CT hepatic angiogram (Right hepatic artery) Catheter-directed CT hepatic angiogram (Left hepatic artery) Tc-99m-macroaggregated albumin SPECT/CT © Department of Nuclear Medicine and PET Dr Yung H Kao, Email: yung.h.kao@gmail.com Kao et al. State-of-the-art yttrium-90 selective internal radiation therapy: Technical aspects of artery-specific SPECT/CT partition model dosimetry. J Nucl Med. 2011; 52 (Supplement 1):1084. Supplemental Figure 3 : Worked example of sub-lesional dosimetry by artery-specific SPECT/CT partition modeling

27. Catheter-directed CT hepatic angiogram (Right hepatic artery) Catheter-directed CT hepatic angiogram (Left hepatic artery) Tc-99m-macroaggregated albumin SPECT/CT © Department of Nuclear Medicine and PET Dr Yung H Kao, Email: yung.h.kao@gmail.com Kao et al. State-of-the-art yttrium-90 selective internal radiation therapy: Technical aspects of artery-specific SPECT/CT partition model dosimetry. J Nucl Med. 2011; 52 (Supplement 1):1084. Supplemental Figure 3 : Worked example of sub-lesional dosimetry by artery-specific SPECT/CT partition modeling

28. Catheter-directed CT hepatic angiogram (Right hepatic artery) Catheter-directed CT hepatic angiogram (Left hepatic artery) Tc-99m-macroaggregated albumin SPECT/CT © Department of Nuclear Medicine and PET Dr Yung H Kao, Email: yung.h.kao@gmail.com Kao et al. State-of-the-art yttrium-90 selective internal radiation therapy: Technical aspects of artery-specific SPECT/CT partition model dosimetry. J Nucl Med. 2011; 52 (Supplement 1):1084. Supplemental Figure 3 : Worked example of sub-lesional dosimetry by artery-specific SPECT/CT partition modeling

29. Catheter-directed CT hepatic angiogram (Right hepatic artery) Catheter-directed CT hepatic angiogram (Left hepatic artery) Tc-99m-macroaggregated albumin SPECT/CT © Department of Nuclear Medicine and PET Dr Yung H Kao, Email: yung.h.kao@gmail.com Kao et al. State-of-the-art yttrium-90 selective internal radiation therapy: Technical aspects of artery-specific SPECT/CT partition model dosimetry. J Nucl Med. 2011; 52 (Supplement 1):1084. Supplemental Figure 3 : Worked example of sub-lesional dosimetry by artery-specific SPECT/CT partition modeling

30. Catheter-directed CT hepatic angiogram (Right hepatic artery) Catheter-directed CT hepatic angiogram (Left hepatic artery) Tc-99m-macroaggregated albumin SPECT/CT © Department of Nuclear Medicine and PET Dr Yung H Kao, Email: yung.h.kao@gmail.com Kao et al. State-of-the-art yttrium-90 selective internal radiation therapy: Technical aspects of artery-specific SPECT/CT partition model dosimetry. J Nucl Med. 2011; 52 (Supplement 1):1084. Supplemental Figure 3 : Worked example of sub-lesional dosimetry by artery-specific SPECT/CT partition modeling

31. Catheter-directed CT hepatic angiogram (Right hepatic artery) Catheter-directed CT hepatic angiogram (Left hepatic artery) Tc-99m-macroaggregated albumin SPECT/CT © Department of Nuclear Medicine and PET Dr Yung H Kao, Email: yung.h.kao@gmail.com Kao et al. State-of-the-art yttrium-90 selective internal radiation therapy: Technical aspects of artery-specific SPECT/CT partition model dosimetry. J Nucl Med. 2011; 52 (Supplement 1):1084. Supplemental Figure 3 : Worked example of sub-lesional dosimetry by artery-specific SPECT/CT partition modeling

32. Catheter-directed CT hepatic angiogram (Right hepatic artery) Catheter-directed CT hepatic angiogram (Left hepatic artery) Tc-99m-macroaggregated albumin SPECT/CT © Department of Nuclear Medicine and PET Dr Yung H Kao, Email: yung.h.kao@gmail.com Kao et al. State-of-the-art yttrium-90 selective internal radiation therapy: Technical aspects of artery-specific SPECT/CT partition model dosimetry. J Nucl Med. 2011; 52 (Supplement 1):1084. Supplemental Figure 3 : Worked example of sub-lesional dosimetry by artery-specific SPECT/CT partition modeling

33. Catheter-directed CT hepatic angiogram (Right hepatic artery) Catheter-directed CT hepatic angiogram (Left hepatic artery) Tc-99m-macroaggregated albumin SPECT/CT © Department of Nuclear Medicine and PET Dr Yung H Kao, Email: yung.h.kao@gmail.com Kao et al. State-of-the-art yttrium-90 selective internal radiation therapy: Technical aspects of artery-specific SPECT/CT partition model dosimetry. J Nucl Med. 2011; 52 (Supplement 1):1084. Supplemental Figure 3 : Worked example of sub-lesional dosimetry by artery-specific SPECT/CT partition modeling

34. Catheter-directed CT hepatic angiogram (Right hepatic artery) Catheter-directed CT hepatic angiogram (Left hepatic artery) Tc-99m-macroaggregated albumin SPECT/CT © Department of Nuclear Medicine and PET Dr Yung H Kao, Email: yung.h.kao@gmail.com Kao et al. State-of-the-art yttrium-90 selective internal radiation therapy: Technical aspects of artery-specific SPECT/CT partition model dosimetry. J Nucl Med. 2011; 52 (Supplement 1):1084. Supplemental Figure 3 : Worked example of sub-lesional dosimetry by artery-specific SPECT/CT partition modeling

35. Catheter-directed CT hepatic angiogram (Right hepatic artery) Catheter-directed CT hepatic angiogram (Left hepatic artery) Tc-99m-macroaggregated albumin SPECT/CT © Department of Nuclear Medicine and PET Dr Yung H Kao, Email: yung.h.kao@gmail.com Kao et al. State-of-the-art yttrium-90 selective internal radiation therapy: Technical aspects of artery-specific SPECT/CT partition model dosimetry. J Nucl Med. 2011; 52 (Supplement 1):1084. Supplemental Figure 3 : Worked example of sub-lesional dosimetry by artery-specific SPECT/CT partition modeling

42. © Department of Nuclear Medicine and PET Dr Yung H Kao, Email: yung.h.kao@gmail.com Kao et al. State-of-the-art yttrium-90 selective internal radiation therapy: Technical aspects of artery-specific SPECT/CT partition model dosimetry. J Nucl Med. 2011; 52 (Supplement 1):1084. www.facebook.com/radioembolization SNM 2011 poster exhibit, dosimetric worksheet and more worked examples are available for download at: www.sgh.com.sg/Clinical-Departments-Centers/Nuclear-Medicine-PET