Hermes hybrid viewer software

Ablative radiation dose (>190 Gy) was intended to be delivered in the target tumor and cause complete tumor destruction (2 (link)). This was achieved via the intra-arterial delivery of ⁹⁰Y glass microspheres (Boston Scientific, Marlborough, MA, USA) super-selectively within the tumor-containing liver segment(s). For tumor dosimetry manufacturer uses a single compartment MIRD approach (28 (link)). This approach assumes uniform particle distribution between a tumor and uninvolved liver parenchyma within a treated segment. It takes into account lung shunt fraction and residual vial radiation activity (29 (link)). Radiation dose delivered to the target tumor and segment was calculated using the following formula:
$$D(segment)=50\frac{Gy·kg}{GBq}\times A\times (1-LSF)\times \frac{(1-R)}{M_S}$$
Here D is the absorbed radiation dose (Gy); A is the vial radioactivity (GBq); LSF is the lung shunt fraction; R is the residual activity (GBq); M is the segment mass (kg) which is calculated by: M_S= segment volume (cm³) × 1.03 kg/1000 cm³.
To measure radiation dose delivered to the tumor, volumetric segmentations of regions of interest (ROI) of the target tumors and the intended-to-treat Couinaud liver segments were performed on pre-treatment diagnostic contrast-enhanced CT scans (obtained within 6-weeks from RS) using Hermes Hybrid Viewer software (Hermes Medical Solutions, Stockholm, Sweden).