A microdosimetry model of kidney by GATE Monte Carlo simulation using a nonuniform activity distribution in digital phantom of nephron

OBJECTIVES

As the main pathway for the clearance of radiopharmaceutical from the body, kidney is a dose-limiting organ in medical application of radionuclides. Because of its unique physiology, radioactivity is seen to concentrate on kidney nonuniformly. This nonuniformity can be considered in nephron microstructures. A microdosimetry model of kidney is necessary to include the nonuniform distribution in internal radiation dosimetry.

METHOD

Implementing the microdosimetry model requires, first, a geometry phantom of nephrons. Stylized phantoms cannot distribute activities inside nephron compartments nonuniformly. A phantom of nephron was generated by a preliminary three-dimensional graphic model and was converted to a proper format of digital phantom. The phantom was fed to GATE Monte Carlo toolkits. Simulations were performed and S-values for five radionuclides (Tc-99m, In-111, Lu-177, Ac-225 and Bi-212) were calculated and compared with corresponding results published in the literature derived with a stylized phantom of nephron. Activity was distributed nonuniformly according to the kinetics of two mainly used diagnostic tracers (diethylenetriaminepetaacetate and ethylenedicysteine) and absorbed dose of nephron cells were calculated.

RESULTS

A good correlation was shown between the generated phantom microdosimetry model and stylized model and revealed the phantom can be used for future microdosimetry studies of kidney to evaluate radiobiological effects of internal radiation from various diagnostic and therapeutic radiopharmaceuticals. Absorbed dose of cells for nonuniform distribution showed that some cells in a nephron compartment receive higher dose than (more than two-fold) that of compartment average dose.

CONCLUSION

Average dose of nephron is not a reliable parameter for nephrotoxicity evaluation.

Improving molecular radiotherapy dosimetry using anthropomorphic calibration

The optimised delivery of Molecular Radiotherapy requires individualised calculation of absorbed dose to both targeted lesions and neighbouring healthy tissue. To achieve this, accurate quantification of the activity distribution in the patient by external detection is vital.

METHODS

This work extends specific anatomy-related calibration to true organ shapes. A set of patient-specific 3D printed organ inserts based on a diagnostic CT scan was produced, comprising the liver, spleen and both kidneys. The inserts were used to calculate patient-specific calibration factors for ¹⁷⁷Lu. These calibration factors were compared with previously reported calibration factors for corresponding organ models based on the Cristy and Eckerman phantom series and for a comparably sized sphere. Monte Carlo calculations of the patient-specific radiation dose were performed for comparison with current clinical dosimetry methods for these data.

RESULTS

Patient-specific calibration factors are shown to be dependent on the volume, shape and position of the organ containing activity with a corresponding impact on the calculation of the dose to the patient. The impact of organ morphology on calculated dose is reduced when the dominant contributor to dose is beta particles. This is due to the small range of beta particles in tissue. Overestimations of recovered activity and hence dose of up to 135% are observed.

CONCLUSION

For accurate quantification to be performed calibration factors accounting for organ size, shape and position must be used. Such quantification is vital if accurate, patient-specific dosimetry is to be achieved.

PATIENT-SPECIFIC DOSIMETRY FOR PEDIATRIC IMAGING OF 99mTc-DIMERCAPTOSUCCINIC ACID WITH GATE MONTE CARLO CODE

In this study, radiation absorbed dose of 99mTc-dimercaptosuccinic acid (DMSA) in critical organs was calculated using Monte Carlo simulation. Ten child patients with genitourinary abnormalities were imaged using a series of planar, SPECT and MRI, after injection with 99mTc-DMSA. Patient-specific organ segmentation was performed on MRI and used as input in GATE. Organs with substantial uptake included kidneys, bladder and liver. The mean organ absorbed dose coefficients (mGy/MBq) were 0.063, 0.058, 0.018, 0.016, 0.013 and 0.010 for the right kidney, left kidney, bones, urinary bladder wall, liver and gonads, respectively. The absorbed dose coefficients in the remainder of the body was 0.012 mGy/MBq. The authors implemented an image-based Monte Carlo method for patient-specific 3D absorbed dose calculation. This study also demonstrates the possibility to obtain patient-specific attenuation map from MRI to be used for the simulations of radiation transport and energy deposition in phantom using Monte Carlo methods.

The importance of BMI in dosimetry of 153Sm-EDTMP bone pain palliation therapy: A Monte Carlo study

Using digital phantoms as an atlas compared to acquiring CT data for internal radionuclide dosimetry decreases patient overall radiation dose and reduces the required analysis effort and time for organ segmentation. The drawback is that the phantom may not match exactly with the patient. We assessed the effect of varying BMIs on dosimetry results for a bone pain palliation agent, ¹⁵³Sm-EDTMP. The simulation was done using the GATE Monte Carlo code. Female XCAT phantoms with the following different BMIs were employed: 18.6, 20.8, 22.1, 26.8, 30.3 and 34.7kg/m². S-factors (mGy/MBq.s) and SAFs (kg^-1) were calculated for the dosimetry of the radiation from major source organs including spine, ribs, kidney and bladder into different target organs as well as whole body dosimetry from spine. The differences in dose estimates from different phantoms compared to those from the phantom with BMI of 26.8kg/m² as the reference, were calculated for both gamma and beta radiations. The relative differences (RD) of the S-factors or SAFs from the values of reference phantom were calculated. RDs greater than 10% and 100% were frequent in radiations to organs for photon and beta particles, respectively. The relative differences in whole body SAFs from the reference phantom were 15.4%, 7%, 4.2%, -9.8% and -1.4% for BMIs of 18.6, 20.8, 22.1, 30.3 and 34.7kg/m², respectively. The differences in whole body S-factors for the phantoms with BMIs of 18.6, 20.8, 22.1, 30.3 and 34.7kg/m² were 39.5%, 19.4%, 8.8%, -7.9% and -4.3%, respectively. The dosimetry of the gamma photons and beta particles changes substantially with the use of phantoms with different BMIs. The change in S-factors is important for dose calculation and can change the prescribed therapeutic dose of ¹⁵³Sm-EDTMP. Thus a phantom with BMI better matched to the patient is suggested for therapeutic purposes where dose estimates closer to those in the actual patient are required.