Perspective: optimization of liver-SIRT by dosimetry assessment using pinhole bremsstrahlung SPECT during the catheterization procedure

Bremsstrahlung pinhole SPECT provided similar results than PET, and is usable for the dosimetry assessment of the liver and of the tumors with diameter higher than 2.8 cm. The price of a single head gamma camera is only about tenfold that of a liver-SIRT procedure and it could be advisable to install one in the catheterization room. This would allow implementing a dosimetry assessment during the liver-SIRT procedure with the major advantage of not moving the catheter, and at the end, injecting the optimal activity that provides the highest absorbed dose to the tumors while remaining safe for the surrounding liver. This may definitely improve the patient outcome. Multi-pinhole helical SPECT is under development to image patients.