Quantitative Dosimetry for Yttrium-90 Radionuclide Therapy: Tumor Dose Predicts Fluorodeoxyglucose Positron Emission Tomography Response in Hepatic Metastatic Melanoma
Quantitative Dosimetry for Yttrium-90 Radionuclide Therapy: Tumor Dose Predicts Fluorodeoxyglucose Positron Emission Tomography Response in Hepatic Metastatic Melanoma
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DOI：
10.1016/j.jvir.2013.08.021
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发表时间：
2014-02-01
影响因子：
2.9
通讯作者：
Fox, Tim
中科院分区：
文献类型：
--
作者：
Eaton, Bree R.;Kim, Hyun S.;Fox, Tim
目的：评估一种新的方法，用于生成患者特异性体积剂量计算，并分析肝黑色素瘤转移瘤放射性栓塞后肿瘤剂量与正电子发射断层扫描（PET）反应之间的关系。方法和材料：将Y-90放射性栓塞后获得的Y-90韧致辐射单光子发射计算机断层扫描（SPECT）/计算机断层扫描（CT）与已发表的Y-90进行卷积。90蒙特卡罗估计剂量沉积内核创建三维剂量分布。根据磁共振成像或PET/CT成像手动定义的肿瘤体积计算剂量-体积直方图。肿瘤反应通过最大标准化摄取值（SUVmax）和总病变糖酵解（TLG.Results）的绝对减少来评估：7例患者的30个肿瘤用Y-90治疗肝转移性黑色素瘤，治疗前和治疗后可获得Y-90 SPECT/CT和PET/CT用于分析。每个肿瘤体积的最小、平均和最大剂量的中位数（范围）分别为16.9戈伊（5.7-43.5戈伊）、28.6戈伊（13.8-65.6戈伊）和36.6戈伊（20-124戈伊）。在治疗后2.8个月（范围：1.2-7.9个月）的中位时间，通过氟脱氧葡萄糖PET/CT评估缓解。平均肿瘤剂量（P = 0.03）和接受>= 50戈伊的肿瘤体积百分比（P <0.01）显著预测肿瘤SUVmax的降低，而最大肿瘤剂量预测肿瘤TLG的降低（P <0.01）。显着的剂量-反应关系点的放射性核素治疗的患者特异性吸收剂量计算的临床效用。
Purpose: To assess a new method for generating patient-specific volumetric dose calculations and analyze the relationship between tumor dose and positron emission tomography (PET) response after radioembolization of hepatic melanoma metastases.Methods and Materials: Yttrium-90 (Y-90) bremsstrahlung single photon emission computed tomography (SPECT)/computed tomography (CT) acquired after Y-90 radioembolization was convolved with published Y-90 Monte Carlo estimated dose deposition kernels to create a three-dimensional dose distribution. Dose-volume histograms were calculated for tumor volumes manually defined from magnetic resonance imaging or PET/CT imaging. Tumor response was assessed by absolute reduction in maximum standardized uptake value (SUVmax) and total lesion glycolysis (TLG).Results: Seven patients with 30 tumors treated with Y-90 for hepatic metastatic melanoma with available Y-90 SPECT/CT and PET/CT before and after treatment were identified for analysis. The median (range) for minimum, mean, and maximum dose per tumor volume was 16.9 Gy (5.7-43.5 Gy), 28.6 Gy (13.8-65.6 Gy) and 36.6 Gy (20-124 Gy), respectively. Response was assessed by fluorodeoxyglucose PET/CT at a median time after treatment of 2.8 months (range, 1.2-7.9 months). Mean tumor dose (P = .03) and the percentage of tumor volume receiving >= 50 Gy (P < .01) significantly predicted for decrease in tumor SUVmax, whereas Maximum tumor dose predicted for decrease hi tumor TLG (P < .01).Conclusions: Volumetric dose calculations showed a statistically significant association with metabolic tumor response. The significant dose-response relationship points to the clinical utility of patient-specific absorbed dose calculations for radionuclide therapy.