Table 3.

Treatment evaluation recommendations for the use of SIRT with ⁹⁰Y-resin microspheres

Recommendation number	Recommendation	Strength of agreement
Treatment verification
R41	It is important to verify that the position/location of the catheter is the same during SIRT as it was during the 99mTc-MAA simulation by visually comparing the positions on angiography	Strong
R42	Post-SIRT residual activity of microspheres in the vial, tubing system and syringe should be measured	Strong
R43	Post-SIRT imaging for treatment verification is used for dosimetry and visual verification	Strong
R44	Post-SIRT imaging for treatment verification is used for future (re)-SIRT	Moderate
R45	Post-SIRT imaging should be performed using the best option available—it should be visual and quantitative and therefore 90Y-PET is preferred (when 90Y-PET is not available, BECT is an acceptable alternative—but is difficult to use to get quantitative verification)	Strong
R46	Post-SIRT dosimetry is recommended	Strong
Treatment response evaluation
R47	When post-SIRT imaging and/or dosimetry shows areas of possible insufficient treatment of the tumour, it is recommended to wait for follow-up response imaging before deciding on the need to re-treat	Moderate

BECT, ⁹⁰Y bremsstrahlung emission computed tomography; PET, positron emission tomography; SIRT, selective internal radiation therapy; ^99mTc-MAA, technetium-99 m labelled macroaggregated albumin