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Purpose  The efficiency of radioembolization procedures could be greatly enhanced if results of the  99m Tc‐ MAA  pretreatment procedure were immediately available in the interventional suite, enabling 1‐day procedures as a result of direct estimation of the hepatic radiation dose and lung shunt fraction. This would, however, require a relatively fast, but still quantitative,  SPECT  procedure, which might be achieved with acquisition protocols using nonuniform durations of the projection images.    Methods   SPECT  liver images of the 150‐ MB q  99m Tc‐ MAA  pretreatment procedure were simulated for eight different lesion locations and two different lesion sizes using the digital  XCAT  phantom for both single‐ and dual‐head scanning geometries with respective total acquisition times of 1, 2, 5, 10, and 30 min. Three nonuniform projection‐time acquisition protocols (“half‐circle  SPECT  ( HCS ),” “nonuniform  SPECT  ( NUS ) I,” and “ NUS II ”) for fast quantitative  SPECT  of the liver were designed and compared with the standard uniform projection‐time protocol. Images were evaluated in terms of contrast‐to‐noise ratio ( CNR ), activity recovery coefficient ( ARC ), tumor/non‐tumor (T/N) activity concentration ratio, and lung shunt fraction ( LSF ) estimation. In addition, image quality was verified with a physical phantom experiment, reconstructed with both clinical and Monte Carlo‐based reconstruction software.    Results  Simulations showed no substantial change in image quality and dosimetry by usage of a nonuniform projection‐time acquisition protocol. Upon shortening acquisition times,  CNR  dropped, but  ARC , T/N ratio, and  LSF  estimates were stable across all simulated acquisition times. Results of the physical phantom were in agreement with those of the simulations.    Conclusion  Both uniform and nonuniform projection‐time acquisition liver  SPECT  protocols yield accurate dosimetric metrics for radioembolization treatment planning in the interventional suite within 10 min, without compromising image quality. Consequently, fast quantitative  SPECT  of the liver in the interventional suite is feasible.

Fast technetium‐99m liver SPECT for evaluation of the pretreatment procedure for radioembolization dosimetry