Impact of the dosimetry approach on the resulting (90)Y radioembolization planned absorbed doses based on (99m)Tc-MAA SPECT-CT: is there agreement between dosimetry methods?
Impact of the dosimetry approach on the resulting (90)Y radioembolization planned absorbed doses based on (99m)Tc-MAA SPECT-CT: is there agreement between dosimetry methods?
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DOI：
10.1186/s40658-020-00343-6
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发表时间：
2020-12-07
期刊：
影响因子：
4
通讯作者：
Martí-Climent JM
中科院分区：
文献类型：
--
作者：
Morán V;Prieto E;Sancho L;Rodríguez-Fraile M;Soria L;Zubiria A;Martí-Climent JM
在放射性栓塞之前，使用99 mTc-大聚集白蛋白作为90 Y-微球替代物进行模拟。采集伽马射线照相术图像（平面、SPECT或SPECT-CT）以评价肝内90 Y-微球分布并检测可能的肝外和肺分流。这些图像可用于治疗前剂量测定评估，以计算将获得最佳肿瘤反应同时保留健康组织的90 Y活性。有几种剂量测定方法可用，但对计算吸收剂量的最佳方法仍没有达成共识。本研究的目的是回顾性评价使用不同剂量测定方法对基于99 mTc-MAA图像的90 Y放射栓塞治疗前吸收剂量评价的影响。评价了分区模型（PM）和3D体素剂量测定方法（3D-VDM）（剂量点核卷积和局部沉积方法）产生的感兴趣体积内的吸收剂量。此外，开发了一种新的“多肿瘤分区模型”（MTPM）。剂量测定方法之间的差异进行了评价的平均吸收剂量和剂量体积直方图内的体积感兴趣。剂量测定方法之间的平均吸收剂量的差异在肿瘤体积中比在非肿瘤体积中高。MTPM和两种3D-VDM之间的差异显著低于PM和任何3D-VDM之间观察到的差异。PM和其他研究的剂量测定方法之间的相关性和一致性较差。从3D-VDM获得的DVH在健康肝脏和个体肿瘤中非常相似。虽然在吸收剂量（单位：戈伊）方面，两种3D-VDM之间没有发现相关的全局差异，但观察到了重要的逐体素差异。研究的90 Y放射性栓塞治疗的剂量测定方法之间存在显著差异。差异不会对健康组织的治疗计划产生实质性影响，但会对肿瘤肝脏产生影响。肿瘤的个体分割和评估是必不可少的。在多发肿瘤患者中，PM的应用不是最佳的，建议改为3D-VDM或新的MTPM。如果3D-VDM方法不可用，MTPM是最佳选择。此外，两种3D-VDM方法可以被模糊地使用。在线版本包含补充材料，可通过10.1186/s40658-020-00343-6获得。
Prior radioembolization, a simulation using 99mTc-macroaggregated albumin as 90Y-microspheres surrogate is performed. Gamma scintigraphy images (planar, SPECT, or SPECT-CT) are acquired to evaluate intrahepatic 90Y-microspheres distribution and detect possible extrahepatic and lung shunting. These images may be used for pre-treatment dosimetry evaluation to calculate the 90Y activity that would get an optimal tumor response while sparing healthy tissues. Several dosimetry methods are available, but there is still no consensus on the best methodology to calculate absorbed doses. The goal of this study was to retrospectively evaluate the impact of using different dosimetry approaches on the resulting 90Y-radioembolization pre-treatment absorbed dose evaluation based on 99mTc-MAA images. Absorbed doses within volumes of interest resulting from partition model (PM) and 3D voxel dosimetry methods (3D-VDM) (dose-point kernel convolution and local deposition method) were evaluated. Additionally, a new “Multi-tumor Partition Model” (MTPM) was developed. The differences among dosimetry approaches were evaluated in terms of mean absorbed dose and dose volume histograms within the volumes of interest. Differences in mean absorbed dose among dosimetry methods are higher in tumor volumes than in non-tumoral ones. The differences between MTPM and both 3D-VDM were substantially lower than those observed between PM and any 3D-VDM. A poor correlation and concordance were found between PM and the other studied dosimetry approaches. DVH obtained from either 3D-VDM are pretty similar in both healthy liver and individual tumors. Although no relevant global differences, in terms of absorbed dose in Gy, between both 3D-VDM were found, important voxel-by-voxel differences have been observed. Significant differences among the studied dosimetry approaches for 90Y-radioembolization treatments exist. Differences do not yield a substantial impact in treatment planning for healthy tissue but they do for tumoral liver. An individual segmentation and evaluation of the tumors is essential. In patients with multiple tumors, the application of PM is not optimal and the 3D-VDM or the new MTPM are suggested instead. If a 3D-VDM method is not available, MTPM is the best option. Furthermore, both 3D-VDM approaches may be indistinctly used. The online version contains supplementary material available at 10.1186/s40658-020-00343-6.
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DOI：
10.1007/s00259-010-1549-3
发表时间：
2011-01-01
影响因子：
9.1
作者：
Lassmann, M.;Chiesa, C.;Bardies, M.
通讯作者：
Bardies, M.
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：
1.5
作者：
Garin, Etienne;Lenoir, Laurence;Boucher, Eveline
通讯作者：
Boucher, Eveline
影响因子：
4.3
作者：
Rodriguez-Lago, Iago;Carretero, Cristina;Sangro, Bruno
通讯作者：
Sangro, Bruno
影响因子：
9.3
作者：
Garin, Etienne;Lenoir, Laurence;Boucher, E.
通讯作者：
Boucher, E.