Episode 24: When do we actually need to measure lung shunt fraction before yttrium-90 liver therapy?
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Episode 24: When do we actually need to measure lung shunt fraction before yttrium-90 liver therapy?
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This episode covers a study from the Mallinckrodt Institute of Radiology at Washington University in St. Louis evaluating whether patient-specific lung shunt fraction measurement is necessary for every yttrium-90 selective internal radiation therapy case. Across 354 cases, the authors propose a new pretreatment metric called LSFbound — derived from liver mass, lung mass, and dose thresholds — that identifies which patients can safely skip the macroaggregated albumin imaging workflow. For most cases without large tumors or macrovascular invasion, the lung shunt simply does not constrain treatment planning, offering a path to a streamlined, single-session workflow.
When is patient-specific lung shunt fraction necessary in 90Y selective internal radiation therapy of liver cancer? Thomas et al. Radiology Advances, 2026, 3, umag007.