SPECT/CT image-based dosimetry for Yttrium-90 radionuclide therapy: Application to treatment response.
SPECT/CT image-based dosimetry for Yttrium-90 radionuclide therapy: Application to treatment response.
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DOI：
10.1002/acm2.12400
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发表时间：
2018-09
影响因子：
2.1
通讯作者：
Fox TH
中科院分区：
文献类型：
--
作者：
Potrebko PS;Shridhar R;Biagioli MC;Sensakovic WF;Andl G;Poleszczuk J;Fox TH
这项工作证明了利用治疗后 SPECT/CT 成像的基于体素的 90Y 微球剂量测定的功效，并将其应用于预测肝细胞癌 (HCC) 患者的治疗反应。商业平台（Velocity，瓦里安医疗系统）内的 90Y 微球剂量测定导航仪 (RapidSphere) 已在三个微球病例中进行了演示，这些病例使用优化的轫致辐射 SPECT/CT 进行成像。对于每个病例，使用可变形图像配准将 90Y SPECT/CT 配准到后续诊断 MR/CT。使用已知注射活性的局部沉积方法计算基于体素的剂量分布。该系统允许在任何注册图像数据集上可视化等剂量分布并计算剂量体积直方图（DVH）。剂量分析表明高局部剂量是血流引导近距离放射治疗的特征。在第一个病例中，HCC 肿块表现出对治疗的完全反应，在后续 MR 成像中显示坏死区域。该结果是通过剂量学预测的，因为总肿瘤体积 (GTV) 很好地被处方等剂量体积覆盖 (V150 Gy = 85%)。第二个病例显示出对治疗的部分反应，其特征是 HCC 肿块不完全坏死，并且在后续 MR 成像中残留实性增强区域。该结果是通过剂量分析预测的，因为 GTV 显示处方等剂量体积的覆盖不完全 (V470 Gy = 18%)。第三个病例表现出肝外活动。剂量测定表明，处方（125 Gy）等剂量区域从肝脏延伸到十二指肠（178 Gy 最大剂量）。这预示着毒性，因为患者后来出现了十二指肠溃疡。使用可变形图像配准、计算的等剂量分布和 DVH 来预测结果和并发症的能力，表明了患者特定剂量计算在 90Y 放射栓塞治疗计划中的临床实用性。
This work demonstrates the efficacy of voxel‐based 90Y microsphere dosimetry utilizing post‐therapy SPECT/CT imaging and applies it to the prediction of treatment response for the management of patients with hepatocellular carcinoma (HCC). A 90Y microsphere dosimetry navigator (RapidSphere) within a commercial platform (Velocity, Varian Medical Systems) was demonstrated for three microsphere cases that were imaged using optimized bremsstrahlung SPECT/CT. For each case, the 90Y SPECT/CT was registered to follow‐up diagnostic MR/CT using deformable image registration. The voxel‐based dose distribution was computed using the local deposition method with known injected activity. The system allowed the visualization of the isodose distributions on any of the registered image datasets and the calculation of dose‐volume histograms (DVHs). The dosimetric analysis illustrated high local doses that are characteristic of blood‐flow directed brachytherapy. In the first case, the HCC mass demonstrated a complete response to treatment indicated by a necrotic region in follow‐up MR imaging. This result was dosimetrically predicted since the gross tumor volume (GTV) was well covered by the prescription isodose volume (V150 Gy = 85%). The second case illustrated a partial response to treatment which was characterized by incomplete necrosis of an HCC mass and a remaining area of solid enhancement in follow‐up MR imaging. This result was predicted by dosimetric analysis because the GTV demonstrated incomplete coverage by the prescription isodose volume (V470 Gy = 18%). The third case demonstrated extrahepatic activity. The dosimetry indicated that the prescription (125 Gy) isodose region extended outside of the liver into the duodenum (178 Gy maximum dose). This was predictive of toxicity as the patient later developed a duodenal ulcer. The ability to predict outcomes and complications using deformable image registration, calculated isodose distributions, and DVHs, points to the clinical utility of patient‐specific dose calculations for 90Y radioembolization treatment planning.
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影响因子：
10.6
作者：
Pasciak, Alexander S.;Erwin, William D.
通讯作者：
Erwin, William D.
影响因子：
3.4
作者：
Floridi, C.;Pesapane, F.;Carrafiello, G.
通讯作者：
Carrafiello, G.
影响因子：
3.8
作者：
Sarfaraz, M;Kennedy, AS;Yu, CX
通讯作者：
Yu, CX
影响因子：
4
作者：
Mikell JK;Mahvash A;Siman W;Mourtada F;Kappadath SC
通讯作者：
Kappadath SC
DOI：
10.1016/j.jvir.2013.08.021
发表时间：
2014-02-01
影响因子：
2.9
作者：
Eaton, Bree R.;Kim, Hyun S.;Fox, Tim
通讯作者：
Fox, Tim