TY - JOUR T1 - Implementation of <sup>99m</sup>Tc-GSA SPECT Image-guided Inverse Planning into Palliative Radiotherapy for Diffuse Liver Metastases: A Novel Approach JF - In Vivo JO - In Vivo SP - 1523 LP - 1526 DO - 10.21873/invivo.12862 VL - 36 IS - 3 AU - RYO TOYA AU - TAKAHIRO WATAKABE AU - YUDAI KAI AU - TOMOHIKO MATSUYAMA AU - YOSHIYUKI FUKUGAWA AU - TADASHI MATSUMOTO AU - SHINYA SHIRAISHI AU - YOSHINOBU SHIMOHIGASHI AU - SHO SAEKI AU - TAKURO SAKAGAMI AU - TOSHINORI HIRAI AU - NATSUO OYA Y1 - 2022/05/01 UR - http://iv.iiarjournals.org/content/36/3/1523.abstract N2 - Background/Aim: This is a report of the first clinical implementation of 99mTc-labeled diethylene triamine pentaacetate-galactosyl human serum albumin (99mTc-GSA) single-photon emission computed tomography (SPECT) image-guided inverse planning into palliative radiotherapy (RT) for diffuse liver metastases. Case Report: A 48-year-old man developed chemo-refractory diffuse liver metastases from thymic carcinoma characterized by abdominal pain and distension. Palliative RT was performed with a total dose of 20 Gy in five fractions using double arc volumetric modulated arc therapy to reduce the dose to functional liver defined by 99mTc-GSA SPECT images. His symptoms were immediately relieved after RT and did not experience radiation-induced liver disease. Both Functional Assessment of Cancer Therapy (FACT)-G and FACT-Hep total scores improved after 2 weeks of RT initiation and did not become worse than baseline scores. Conclusion: The 99mTc-GSA SPECT image-guided palliative RT is an effective and safe treatment for patients with diffuse liver metastases. ER -