Comparing voxel-based absorbed dosimetry methods in tumors, liver, lung, and at the liver-lung interface for 90Y microsphere selective internal radiation therapy

EJNMMI Physics - 2015
Justin Mikell1, Armeen Mahvash2, Wendy Siman1, Firas Mourtada3, S Cheenu Kappadath4
1Department of Imaging Physics, The University of Texas MD Anderson Cancer Center, 1155 Pressler St, Unit 1352, Houston, TX, 77030, USA
2Department of Interventional Radiology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.
3Christiana Care Hospital, Newark, DE, USA
4The University of Texas Graduate School of Biomedical Sciences at Houston, Houston, TX, USA

Tóm tắt

Abstract Background

To assess differences between four different voxel-based dosimetry methods (VBDM) for tumor, liver, and lung absorbed doses following 90Y microsphere selective internal radiation therapy (SIRT) based on 90Y bremsstrahlung SPECT/CT, a secondary objective was to estimate the sensitivity of liver and lung absorbed doses due to differences in organ segmentation near the liver-lung interface.

 Methods

Investigated VBDM were Monte Carlo (MC), soft-tissue kernel with density correction (SKD), soft-tissue kernel (SK), and local deposition (LD). Seventeen SIRT cases were analyzed. Mean absorbed doses ( $$ \overline{AD} $$ AD ¯ ) were calculated for tumor, non-tumoral liver (NL), and right lung (RL). Simulations with various SPECT spatial resolutions (FHWMs) and multiple lung shunt fractions (LSs) estimated the accuracy of VBDM at the liver-lung interface. Sensitivity of patient RL and NL $$ \overline{AD} $$ AD ¯ on segmentation near the interface was assessed by excluding portions near the interface.

 Results

SKD, SK, and LD were within 5 % of MC for tumor and NL $$ \overline{AD} $$ AD ¯ . LD and SKD overestimated RL $$ \overline{AD} $$ AD ¯ compared to MC on average by 17 and 20 %, respectively; SK underestimated RL $$ \overline{AD} $$ AD ¯ on average by −60 %. Simulations (20 mm FWHM, 20 % LS) showed that SKD, LD, and MC were within 10 % of the truth deep (>39 mm) in the lung; SK significantly underestimated the absorbed dose deep in the lung by approximately −70 %. All VBDM were within 10 % of truth deep (>12 mm) in the liver. Excluding 1, 2, and 3 cm of RL near the interface changed the resulting RL $$ \overline{AD} $$ AD ¯ by −22, −38, and −48 %, respectively, for all VBDM. An average change of −7 % in the NL $$ \overline{AD} $$ AD ¯ was realized when excluding 3 cm of NL from the interface. $$ \overline{AD} $$ AD ¯ was realized when excluding 3 cm of NL from the interface.

 Conclusions

SKD, SK, and LD are equivalent to MC for tumor and NL $$ \overline{AD} $$ AD ¯ . SK underestimates RL $$ \overline{AD} $$ AD ¯ relative to MC whereas LD and SKD overestimate. RL $$ \overline{AD} $$ AD ¯ is strongly influenced by the liver-lung interface.

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Tài liệu tham khảo

Therasphere (TM). Biocompatibles UK Ltd: package insert. 2014.

SIR-Sphere (TM). Sirtex Medical Inc.: package insert. 2011.

Ho S, Lau WY, Leung TW, Chan M, Ngar YK, Johnson PJ, et al. Partition model for estimating radiation doses from yttrium-90 microspheres in treating hepatic tumours. Eur J Nucl Med. 1996;23(8):947–52.

Dieudonné A, Hobbs RF, Lebtahi R, Maurel F, Baechler S, Wahl RL, et al. Study of the impact of tissue density heterogeneities on 3-dimensional abdominal dosimetry: comparison between dose kernel convolution and direct Monte Carlo methods. J Nucl Med. 2013;54(2):236–43. doi:10.2967/jnumed.112.105825.

Giammarile F, Bodei L, Chiesa C, Flux G, Forrer F, Kraeber-Bodere F, et al. EANM procedure guideline for the treatment of liver cancer and liver metastases with intra-arterial radioactive compounds. Eur J Nucl Med Mol Imaging. 2011;38(7):1393–406. doi:10.1007/s00259-011-1812-2.

Dezarn WA, Cessna JT, DeWerd LA, Feng W, Gates VL, Halama J, et al. Recommendations of the American Association of Physicists in Medicine on dosimetry, imaging, and quality assurance procedures for 90Y microsphere brachytherapy in the treatment of hepatic malignancies. Med Phys. 2011;38(8):4824–45. doi:10.1118/1.3608909.

Garin E, Lenoir L, Rolland Y, Edeline J, Mesbah H, Laffont S, et al. Dosimetry based on 99mTc-macroaggregated albumin SPECT/CT accurately predicts tumor response and survival in hepatocellular carcinoma patients treated with 90Y-loaded glass microspheres: preliminary results. J Nucl Med. 2012;53(2):255–63. doi:10.2967/jnumed.111.094235.

Wondergem M, Smits MLJ, Elschot M, de Jong HW, Verkooijen HM, van den Bosch MA, et al. 99mTc-macroaggregated albumin poorly predicts the intrahepatic distribution of 90Y resin microspheres in hepatic radioembolization. J Nucl Med. 2013. doi:10.2967/jnumed.112.117614.

Yu N, Srinivas SM, DiFilippo FP, Shrikanthan S, Levitin A, McLennan G, et al. Lung dose calculation with SPECT/CT for 90Yittrium radioembolization of liver cancer. Int J Radiat Oncol. 2013;85(3):834–9. doi:10.1016/j.ijrobp.2012.06.051.

Elschot M, Nijsen JFW, Lam MGEH, Smits ML, Prince JF, Viergever MA, et al. 99mTc-MAA overestimates the absorbed dose to the lungs in radioembolization: a quantitative evaluation in patients treated with 166Ho-microspheres. Eur J Nucl Med Mol Imaging. 2014;41(10):1965–75. doi:10.1007/s00259-014-2784-9.

Siman W, Kappadath SC. Energy window based scatter correction for improved 90Y bremsstrahlung imaging [abstract]. J Nucl Med. 2013;54(Supplement 2):527.

Kawrakow I, Rogers DWO. The EGSnrc Code System: Monte Carlo simulation of electron and photon transport. Vol Technical Report PIRS-701. (Ottawa: National Research Council of Canada)

Walters B, Rogers DWO. DOSXYZnrc Users Manual. Ottawa, Ontario, Canada: National Research Council of Canada; 2002.

Berger MJ, Coursey JS, Zucker MA, Chang J. ESTAR, PSTAR, and ASTAR: computer programs for calculating stopping-power and range tables for electrons, protons, and helium ions (version 1.2.3). Gaithersburg, MD.: National Institute of Standards and Technology; 2005. http://www.nist.gov/pml/data/star/. Accessed July 20, 2015.

Snyder WS, Cook MJ, Nasset ES, Karhausen LR, Howells GP, Tipton IH. Report on the task group on reference man. In: ICRP Publ. No. 23. Oxford: International Commission on Radiological Protection; 1975.

Cristy M, Eckerman KF. Specific absorbed fractions of energy at various ages from internal photon sources: 1. Methods. 1987.

Eckerman KF, Endo A. User guide to the ICRP CD and the DECDATA software. Ann ICRP. 2008;38(3):e1–25. doi:10.1016/j.icrp.2008.10.001.

Lanconelli N, Pacilio M, Lo Meo S, Botta F, Di Dia A, Aroche AT, et al. A free database of radionuclide voxel S values for the dosimetry of nonuniform activity distributions. Phys Med Biol. 2012;57(2):517–33. doi:10.1088/0031-9155/57/2/517.

Valentin J, Streffer C. Basic anatomical and physiological data for use in radiological protection: Reference values—ICRP Publication 89. Ann ICRP. 2002;32(3-4):1-265. doi:10.1016/S0146-6453(03)00002-2.

Pasciak AS, Bourgeois AC, Bradley YC. A comparison of techniques for 90Y PET/CT image-based dosimetry following radioembolization with resin microspheres. Front Oncol. 2014;4. doi:10.3389/fonc.2014.00121

Kao Y-H, Steinberg JD, Tay Y-S, Lim GK, Yan J, Townsend DW, et al. Post-radioembolization yttrium-90 PET/CT—part 2: dose-response and tumor predictive dosimetry for resin microspheres. EJNMMI Res. 2013;3(1):57. doi:10.1186/2191-219X-3-57.

Pasciak AS, Erwin WD. Effect of voxel size and computation method on Tc-99m MAA SPECT/CT-based dose estimation for Y-90 microsphere therapy. IEEE Trans Med Imaging. 2009;28(11):1754–8. doi:10.1109/TMI.2009.2022753.

Sanchez-Garcia M, Gardin I, Lebtahi R, Dieudonné A. A new approach for dose calculation in targeted radionuclide therapy (TRT) based on collapsed cone superposition: validation with 90Y. Phys Med Biol. 2014;59(17):4769. doi:10.1088/0031-9155/59/17/4769.

Busse N, Erwin W, Pan T. Evaluation of a semiautomated lung mass calculation technique for internal dosimetry applications. Med Phys. 2013;40(12):122503. doi:10.1118/1.4830433.

Rong X, Du Y, Ljungberg M, Rault E, Vandenberghe S, Frey EC. Development and evaluation of an improved quantitative 90Y bremsstrahlung SPECT method. Med Phys. 2012;39(5):2346–58. doi:10.1118/1.3700174.

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