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Plachouris D, Mountris KA, Papadimitroulas P, Spyridonidis T, Katsanos K, Apostolopoulos D, Papathanasiou N, Hazle JD, Visvikis D, Kagadis GC. Clinical Evaluation of a Three-Dimensional Internal Dosimetry Technique for Liver Radioembolization with 90Y Microspheres Using Dose Voxel Kernels. Cancer Biother Radiopharm 2021; 36:809-819. [PMID: 33656372 DOI: 10.1089/cbr.2020.4554] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
Background: The purpose of this study was to develop a rapid, reliable, and efficient tool for three-dimensional (3D) dosimetry treatment planning and post-treatment evaluation of liver radioembolization with 90Y microspheres, using tissue-specific dose voxel kernels (DVKs) that can be used in everyday clinical practice. Materials and Methods: Two tissue-specific DVKs for 90Y were calculated through Monte Carlo (MC) simulations. DVKs for the liver and lungs were generated, and the dose distribution was compared with direct MC simulations. A method was developed to produce a 3D dose map by convolving the calculated DVKs with the activity biodistribution derived from clinical single-photon emission computed tomography (SPECT) or positron emission tomography (PET) images. Image registration for the SPECT or PET images with the corresponding computed tomography scans was performed before dosimetry calculation. The authors first compared the DVK convolution dosimetry with a direct full MC simulation on an XCAT anthropomorphic phantom. They then tested it in 25 individual clinical cases of patients who underwent 90Y therapy. All MC simulations were carried out using the GATE MC toolkit. Results: Comparison of the measured absorbed dose using tissue-specific DVKs and direct MC simulation on 25 patients revealed a mean difference of 1.07% ± 1.43% for the liver and 1.03% ± 1.21% for the tumor tissue, respectively. The largest difference between DVK convolution and full MC dosimetry was observed for the lung tissue (10.16% ± 1.20%). The DVK statistical uncertainty was <0.75% for both media. Conclusions: This semiautomatic algorithm is capable of performing rapid, accurate, and efficient 3D dosimetry. The proposed method considers tissue and activity heterogeneity using tissue-specific DVKs. Furthermore, this method provides results in <1 min, making it suitable for everyday clinical practice.
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Affiliation(s)
- Dimitris Plachouris
- 3DMI Research Group, Department of Medical Physics, School of Medicine, University of Patras, Rion, Greece
| | - Konstantinos A Mountris
- Department of Electrical Engineering, Aragon Institute of Engineering Research, IIS Aragon, University of Zaragoza, Zaragoza, Spain
| | | | - Trifon Spyridonidis
- Department of Nuclear Medicine, School of Medicine, University of Patras, Rion, Greece
| | | | | | | | - John D Hazle
- Department of Imaging Physics, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | | | - George C Kagadis
- 3DMI Research Group, Department of Medical Physics, School of Medicine, University of Patras, Rion, Greece.,Department of Imaging Physics, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
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