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. 2023 Feb;33(1):35-45.
doi: 10.1016/j.zemedi.2022.11.003. Epub 2022 Dec 17.

Voxel-S-value methods adapted to heterogeneous media for quantitative Y-90 microsphere radioembolization dosimetry

Gefei Chen  1 , Zhonglin Lu  2 , Yue Chen  3 , Greta S P Mok  4
Affiliations

Voxel-S-value methods adapted to heterogeneous media for quantitative Y-90 microsphere radioembolization dosimetry

Gefei Chen et al. Z Med Phys. 2023 Feb.

Abstract

Purpose: The absorbed dose estimation from Voxel-S-Value (VSV) method in heterogeneous media is suboptimal as VSVs are calculated in homogeneous media. The aim of this study is to develop and evaluate new VSV methods in order to enhance the accuracy of Y-90 microspheres absorbed dose estimation in liver, lungs, tumors and lung-liver interface regions.

Methods: Ten patients with Y-90 microspheres SPECT/CT and PET/CT data, six of whom had additional Tc-99m-macroaggregated albumin SPECT/CT data, were analyzed from the Deep Blue Data Repository. Seven existing VSV methods along with three newly proposed VSV methods were evaluated: liver and lung kernel with center voxel scaling (LiLuCK), liver kernel with density correction and lung kernel with center voxel scaling (LiKDLuCK), liver kernel with center voxel scaling and lung kernel with density correction (LiCKLuKD). Monte Carlo (MC) results were regarded as the gold standard. Absolute absorbed dose errors (%AADE) of these methods for the liver, lungs, tumors, upper liver, and lower lungs were assessed.

Results: Liver and tumor's median %AADE of all methods were <3% for three types of imaging data. In the lungs, however, three recently proposed VSV methods provided median %AADEs of less than 7%, whereas the differences exceeded 20% for existing methods that did not use a lung kernel. LiCKLuKD could achieve median %AADE <2% in the liver, upper liver and tumors, and median %AADE <7% in the lungs and lower lungs in three types of data.

Conclusion: All methods are consistent with MC in the liver and tumors. Methods with tissue-specific kernel and effective correction achieve smaller errors in lungs. LiCKLuKD has comparable results with MC in absorbed dose estimation of Y-90 radioembolization for all target regions.

Keywords: Quantitative imaging; Radioembolization; Tc-99m macroaggregated albumin; Voxel-S-value; Yttrium-90 microsphere.

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Conflict of interest statement

Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.

Figures

Figure 1
Figure 1
Coronal view of sample quantitative (A) Tc-99m-MAA SPECT/CT, (B) Y-90 microsphere bremsstrahlung SPECT/CT, (C) Y-90 microsphere PET/CT images, and (D) various VOIs for one sample patient.
Figure 2
Figure 2
Sample VSVs used in this study. (A) Validation of the soft tissue VSV generated by GATE v9.0 with N Lanconelli’s result . (B) Profiles of VSVs generated in liver and lung media for Y-90.
Figure 3
Figure 3
Box-whisker plot (displaying the maximum/minimum at the whiskers, the 75/25 percentiles at the boxes, and the median in the center line) of %AADE of each VSV method in Tc-99m-MAA SPECT/CT, Y-90 SPECT/CT and Y-90 PET/CT patient data for (A) liver, (B) lungs, (C) tumor, (D) upper liver, and (E) lower lungs.
Figure 4
Figure 4
Absorbed dose difference map of different VSV methods as compared to MC for a sample patient. (A) Tc-99m-MAA SPECT/CT; (B) Y-90 SPECT/CT; and (C) Y-90 PET/CT. White arrows point out potential overestimation of absorbed dose in the upper liver.
Figure 5
Figure 5
Absorbed dose profiles of each VSV method on the selected liver-lungs boundary region (vertical blue line) in (A) Tc-99m-MAA SPECT/CT, (B) Y-90 SPECT/CT and (C) Y-90 PET/CT patient data. The profile from the MC result is shown as reference.
Figure 6
Figure 6
CDVHs of Y-90 SPECT/CT data for a sample patient based on various absorbed dose conversion methods: (A) liver, (B) tumor and (C) lungs.
See this image and copyright information in PMC

References

    1. Salem R., Gabr A., Riaz A., Mora R., Ali R., Abecassis M., et al. Institutional decision to adopt Y90 as primary treatment for hepatocellular carcinoma informed by a 1,000-patient 15-year experience. Hepatology. 2018;68:1429–1440. - PubMed
    1. Elsayed M., Cheng B., Xing M., Sethi I., Brandon D., Schuster D.M., et al. Comparison of Tc-99m MAA planar versus SPECT/CT imaging for lung shunt fraction evaluation prior to Y-90 radioembolization: are we overestimating lung shunt fraction? CardioVasc Intervent Radiol. 2021;44:254–260. - PubMed
    1. Ho S., Lau W.Y., Leung T.W., Chan M., Johnson P.J., Li A.K. Clinical evaluation of the partition model for estimating radiation doses from yttrium-90 microspheres in the treatment of hepatic cancer. Eur J Nucl Med Mol Imag. 1997;24:293–298. - PubMed
    1. Grosser O.S., Ulrich G., Furth C., Pech M., Ricke J., Amthauer H., et al. Intrahepatic activity distribution in radioembolization with yttrium-90–labeled resin microspheres using the body surface area method—a less than perfect model. J Vasc Interv Radiol. 2015;26:1615–1621. - PubMed
    1. Mikell J.K., Mahvash A., Siman W., Baladandayuthapani V., Mourtada F., Kappadath S.C. Selective internal radiation therapy with yttrium-90 glass microspheres: biases and uncertainties in absorbed dose calculations between clinical dosimetry models. Int J Radiat Oncol* Biol* Phys. 2016;96:888–896. - PMC - PubMed

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