Table 2 Regions to be segmented in complex situations of marked mismatch between radiological and nuclear medicine images, like Figs. 2B, C and D. Use a contrast-enhanced CT co-registered with CT of SPECT if necessary (see also Numerical example section in the Appendix)

1

Whole liver

VOI_CT(whole liver)

CT-based, to quantify volume. Exclude cysts or necrosis from previous treatments.

2

Targeted lesions

VOI_CT(#1)

VOI_CT(#2)

VOI_CT(#3)

CT-based, including low-perfusion region to quantify volume.

Derive respective counts from perfused lesion regions.

3

Non targeted lesion

VOI_CT (non-targeted lesions)

CT-based, including low-perfusion region

4

Perfused liver

VOI_SPECT(PL)

SPECT-based, to determine counts

5

Perfused liver

VOI_CT(PL)

To determine PL volume. To obtain this VOI, Crop 4 within 1

6

Perfused lesion regions

VOI_SPECT(#1)

VOI_SPECT(#2)

VOI_SPECT(#3)

SPECT-based (aided by CT), excluding low-perfusion region , to determine SPECT lesion volume and counts

7

Perfused non-tumoural liver

VOI_SPECT(PNTL)

To obtain the number of counts N. 4 minus 6: N{VOI_SPECT(PL)} − N{∑_iVOI_SPECT(#i)}

8

Perfused non-tumoural liver

VOI_CT(PNTL)

To obtain volume. 5 minus 2: VOI_SPECT(PL) − ΣVOI_CT(#i), limited within 1

9

Non-tumoural whole liver (includes also non-perfused liver)

VOI_CT(NTL)

Non-tumoural whole liver volume is obtained by subtraction:

Volume 1 minus (Volume 2 + Volume 3)

Non-tumoural whole liver counts 4 subtracted of counts in 6 identical to 7

Record the non-tumoural liver-treated volume fraction V_f

\( {\boldsymbol{V}}_{\boldsymbol{f}}=\frac{{\mathbf{VOI}}_{\mathbf{CT}}\left(\mathbf{PNTL}\right)}{{\mathbf{VOI}}_{\mathbf{CT}}\left(\mathbf{NTL}\right)} \)

10

Lung (in case of substantial LSF)

VOI_CT(Lung)

CT-based, to determine volume and counts.