%0 Journal Article %A RYO TOYA %A TAKAHIRO WATAKABE %A YUDAI KAI %A TOMOHIKO MATSUYAMA %A YOSHIYUKI FUKUGAWA %A TADASHI MATSUMOTO %A SHINYA SHIRAISHI %A YOSHINOBU SHIMOHIGASHI %A SHO SAEKI %A TAKURO SAKAGAMI %A TOSHINORI HIRAI %A NATSUO OYA %T Implementation of 99mTc-GSA SPECT Image-guided Inverse Planning into Palliative Radiotherapy for Diffuse Liver Metastases: A Novel Approach %D 2022 %R 10.21873/invivo.12862 %J In Vivo %P 1523-1526 %V 36 %N 3 %X 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. %U https://iv.iiarjournals.org/content/invivo/36/3/1523.full.pdf