Login Register Cart 0
Generic placeholder image

Current Radiopharmaceuticals

Editor-in-Chief

ISSN (Print): 1874-4710
ISSN (Online): 1874-4729

Back
Journal Home About Journal Editorial Board Journal Insight Current Issue Volumes/Issues
Subscribe
Research Article

An In-House 3D Voxel Dosimetric Tool to Compare Predictive and Post- Treatment Dosimetry in 90Y Radioembolization: A Proof of Concept

Author(s): Ornella Ferrando*, Rossana Bampi, Franca Foppiano and Andrea Ciarmiello

Volume 16, Issue 3, 2023

Published on: 06 March, 2023

Page: [214 - 221] Pages: 8

DOI: 10.2174/1874471016666230215102455

Price: $65

Abstract

Aim: The aim of this study was to implement an in-house dosimetric tool to assess tumour- absorbed doses in pre and post-dosimetry for 90Y radioembolization with resin spheres.

Materials and Methods: To perform dosimetric calculations we set up a dosimetric procedure and developed homemade software to calculate tumour absorbed dose and dose volume histograms (DVHs). The method is based on a simplified voxel dosimetry for an estimated 3D absorbed dose and it can be applied to both 99mTc-MAA SPECT/CT and 90Y PET/CT acquisitions for pre and post-dosimetry. We tested the software performance in a retrospective study using the data of 22 patients with hepatocellular carcinoma who underwent radioembolization with 90Y resin spheres in the period 2016-2021. The software calculates tumour doses (mean, minimum and maximum doses) from voxel counts and dose-volume histograms (DVH_spect, DVH_pet) for both 99mTc-MAA SPECT/CT and 90Y PET/CT imaging. DVH_spect and DVH_pet data were analyzed and compared with the aim to assess an agreement between them. Concordance between dosimetric data were evaluated with the Wilcoxon Signed Ranked test, descriptive statistical analysis and Pearson correlation coefficient.

Results: The mean administrated activity was 1313 MBq (range 444 MBq - 2200 MBq). Tumour volumes ranged from 75 mL to 1012 mL. The mean absorbed dose for tumour volume was 161 ± 66 Gy (Dm_spect) and 173 ± 79 Gy (Dm_pet). From Wilcoxon Signed Rank Test the differences between the dosimetric data extrapolated from DVH_spect and DVH_pet results were not significant with α = 0.05 (two-sided test). A good linear correlation was found between 99mTc-MAA and 90Y dosimetric data (Pearson correlation coefficient 0.887 p < 0.001). Generally, DVHs calculated on 99mTc-MAA SPECT/CT and 90Y PET/CT gave comparable results, some discrepancies were observed particularly with those patients where SPECT and PET imaging presented a visual mismatching.

Conclusion: A simplified 3D dosimetry methodology was implemented and tested retrospectively on patient data treated with 90Y resin spheres. Even if the clinical feasibility of our approach has to be further validated on an extended patient cohort, the preliminary results of our study highlight the potential of the implemented dosimetric tool for tumour dose assessment.

Keywords: 90Y, radioembolization, voxel dosimetry, spect/ct, pet/ct, 99mTc-MAA.

« Previous Next »
Graphical Abstract

[1]
Prompers, L.; Bucerius, J.; Brans, B.; Temur, Y.; Berger, L.; Mottaghy, F.M. Selective internal radiation therapy (SIRT) in primary or secondary liver cancer. Methods, 2011, 55(3), 253-257.
[http://dx.doi.org/10.1016/j.ymeth.2011.09.014] [PMID: 21964397]
[2]
Kennedy, A. Radioembolization of hepatic tumors. J. Gastrointest. Oncol., 2014, 5(3), 178-189.
[PMID: 24982766]
[3]
Sirtex package insert for SIR-Spheres® microspheres. NSW, Australia: Sirtex Medical Limited. 2019. Available from: http://www.sirtex.com/media/8163/pi-ec-11.pdf/
[4]
Hermann, A.L.; Dieudonné, A.; Maxime, R.; Manuel, S.; Helena, P.; Gilles, C.; Laurent, C.; Rachida, L.; Vilgrain, V.; Group, S.T. Role of 99mTc-Macroaggregated Albumin SPECT/CT based dosimetry in predicting survival and tumor response of patients with locally advanced and inoperable hepatocellular carcinoma (HCC) treated by selective intra-arterial radiation therapy (SIRT) with yttrium-90 resin microspheres, a cohort from SARAH study. J. Hepatol., 2018, 68(68), S13.
[http://dx.doi.org/10.1016/S0168-8278(18)30243-5]
[5]
Strigari, L.; Sciuto, R.; Rea, S.; Carpanese, L.; Pizzi, G.; Soriani, A.; Iaccarino, G.; Benassi, M.; Ettorre, G.M.; Maini, C.L. Efficacy and toxicity related to treatment of hepatocellular carcinoma with 90Y-SIR spheres: radiobiologic considerations. J. Nucl. Med., 2010, 51(9), 1377-1385.
[http://dx.doi.org/10.2967/jnumed.110.075861] [PMID: 20720056]
[6]
Vauthey, J.; Abdalla, E.K.; Doherty, D.A.; Gertsch, P.; Fenstermacher, M.J.; Loyer, E.M.; Lerut, J.; Materne, R.; Wang, X.; Encarnacion, A.; Herron, D.; Mathey, C.; Ferrari, G.; Charnsangavej, C.; Do, K.A.; Denys, A. Body surface area and body weight predict total liver volume in Western adults. Liver Transpl., 2002, 8(3), 233-240.
[http://dx.doi.org/10.1053/jlts.2002.31654] [PMID: 11910568]
[7]
Levillain, H.; Bagni, O.; Deroose, C.M.; Dieudonné, A.; Gnesin, S.; Grosser, O.S.; Kappadath, S.C.; Kennedy, A.; Kokabi, N.; Liu, D.M.; Madoff, D.C.; Mahvash, A.; Martinez de la Cuesta, A.; Ng, D.C.E.; Paprottka, P.M.; Pettinato, C.; Rodríguez-Fraile, M.; Salem, R.; Sangro, B.; Strigari, L.; Sze, D.Y. de Wit van der veen, B.J.; Flamen, P. International recommendations for personalised selective internal radiation therapy of primary and metastatic liver diseases with yttrium-90 resin microspheres. Eur. J. Nucl. Med. Mol. Imaging, 2021, 48(5), 1570-1584.
[http://dx.doi.org/10.1007/s00259-020-05163-5] [PMID: 33433699]
[8]
Hermann, A.L.; Dieudonné, A.; Ronot, M.; Sanchez, M.; Pereira, H.; Chatellier, G.; Garin, E.; Castera, L.; Lebtahi, R.; Vilgrain, V. Relationship of tumor radiation-absorbed dose to survival and response in hepatocellular carcinoma treated with transarterial radioembolization with yttrium-90 in the SARAH study. Radiology, 2020, 296(3), 673-684.
[http://dx.doi.org/10.1148/radiol.2020191606] [PMID: 32602828]
[9]
Chansanti, O.; Jahangiri, Y.; Matsui, Y.; Adachi, A.; Geeratikun, Y.; Kaufman, J.A.; Kolbeck, K.J.; Stevens, J.S.; Farsad, K. Tumor dose response in yttrium-90 resin microsphere embolization for neuroendocrine liver metastases: a tumor specific analysis with dose estimation using SPECT-CT. J. Vasc. Interv. Radiol., 2017, 28(11), 1528-1535.
[http://dx.doi.org/10.1016/j.jvir.2017.07.008] [PMID: 28888827]
[10]
Council Directive 2013/59/Euratom. Eur. Union, 2013/59, 2014, 57.
[11]
Santoro, L.; Pitalot, L.; Trauchessec, D.; Mora-Ramirez, E.; Kotzki, P.O.; Bardiès, M.; Deshayes, E. Clinical implementation of planet® dose for dosimetric assessment after [177Lu] Lu DOTA TATE: comparison with DosimetryToolkit® and OLINDA/EXM® V1.0. EJNMMI Res., 2021, 11(1), 1.
[http://dx.doi.org/10.1186/s13550-020-00737-8]
[12]
HIBRID 3DTM SIRT - Hermes Medical Solution. 2021.
[13]
SurePlan. Liver 90Y - MIM Software.
[14]
Traino, A.C.; Marcatili, S.; Avigo, C.; Sollini, M.; Erba, P.A.; Mariani, G. Dosimetry for nonuniform activity distributions: A method for the calculation of 3D absorbed-dose distribution without the use of voxel S -values, point kernels, or Monte Carlo simulations. Med. Phys., 2013, 40(4), 042505.
[http://dx.doi.org/10.1118/1.4794473] [PMID: 23556921]
[15]
Bolch, W.E.; Bouchet, L.G.; Robertson, J.S.; Wessels, B.W.; Siegel, J.A.; Howell, R.W.; Erdi, A.K.; Aydogan, E.; Costes, S.; Watson, E.E. MIRD pamphlet no. 17: the dosimetry of nonuniform activity distributions – radionuclide s values at the voxel level. J. Nucl. Med., 1999, 40, 118-368.
[16]
Stabin, M.G.; Sparks, R.B.; Crowe, E. OLINDA/EXM: The second-generation personal computer software for internal dose assessment in nuclear medicine. J. Nucl. Med., 2005, 46(6), 1023-1027.
[PMID: 15937315]
[17]
Stabin, M.G. Recommendations of the american association of physicists in medicine on dosimetry, imaging, and quality assurance procedures for 90Y microsphere brachytherapy in the treatment of hepatic malignancies. Med. Phys., 2011, 38(8), 4824-4845.
[http://dx.doi.org/10.1118/1.3608909]
[18]
Loening, A.M.; Gambhir, S.S. AMIDE: A free software tool for multimodality medical image analysis. Mol. Imaging, 2003, 2(3), 131-137.
[http://dx.doi.org/10.1162/153535003322556877] [PMID: 14649056]
[19]
AMIDE 1.0.4 open source software. Available from: http://amide.sourceforge.net
[20]
Chiesa, C.; Sjogreen-Gleisner, K.; Walrand, S.; Strigari, L.; Flux, G.; Gear, J.; Stokke, C.; Gabina, P.M.; Bernhardt, P.; Konijnenberg, M. EANM dosimetry committee series on standard operational procedures: a unified methodology for 99mTc-MAA pre- and 90Y peri-therapy dosimetry in liver radioembolization with 90Y microspheres. EJNMMI Phys., 2021, 8(1), 77.
[http://dx.doi.org/10.1186/s40658-021-00394-3] [PMID: 34767102]
[21]
OCTAVE 4.02 platform. 2021. http://www.octave.org
[22]
Kennedy, A.S.; Nutting, C.; Coldwell, D.; Gaiser, J.; Drachenberg, C. Pathologic response and microdosimetry of 90Y microspheres in man: Review of four explanted whole livers. Int. J. Radiat. Oncol. Biol. Phys., 2004, 60(5), 1552-1563.
[http://dx.doi.org/10.1016/j.ijrobp.2004.09.004] [PMID: 15590187]
[23]
Garin, E.; Palard, X.; Rolland, Y. Personalised dosimetry in radioembolisation for HCC: Impact on clinical outcome and on trial design. Cancers, 2020, 12(6), 1557.
[http://dx.doi.org/10.3390/cancers12061557] [PMID: 32545572]
[24]
Grosser, O.S.; Ulrich, G.; Furth, C.; Pech, M.; Ricke, J.; Amthauer, H.; Ruf, J. 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(11), 1615-1621.
[http://dx.doi.org/10.1016/j.jvir.2015.07.021] [PMID: 26321017]
[25]
Levillain, H.; Duran Derijckere, I.; Ameye, L.; Guiot, T.; Braat, A.; Meyer, C.; Vanderlinden, B.; Reynaert, N.; Hendlisz, A.; Lam, M.; Deroose, C.M.; Ahmadzadehfar, H.; Flamen, P. Personalised radioembolization improves outcomes in refractory intra-hepatic cholangiocarcinoma: A multicenter study. Eur. J. Nucl. Med. Mol. Imaging, 2019, 46(11), 2270-2279.
[http://dx.doi.org/10.1007/s00259-019-04427-z] [PMID: 31324943]
[26]
van den Hoven, A.F.; Rosenbaum, C.E.N.M.; Elias, S.G.; de Jong, H.W.A.M.; Koopman, M.; Verkooijen, H.M.; Alavi, A.; van den Bosch, M.A.A.J.; Lam, M.G.E.H. Insights into the dose-response relationship of radioembolization with resin 90Y-microspheres: A prospective cohort study in patients with colorectal cancer liver metastases. J. Nucl. Med., 2016, 57(7), 1014-1019.
[http://dx.doi.org/10.2967/jnumed.115.166942] [PMID: 26912436]
[27]
Levillain, H.; Duran Derijckere, I.; Marin, G.; Guiot, T.; Vouche, M.; Reynaert, N.; Hendlisz, A.; Vanderlinden, B.; Flamen, P. 90Y-PET/CT-based dosimetry after selective internal radiation therapy predicts outcome in patients with liver metastases from colorectal cancer. EJNMMI Res., 2018, 8(1), 60.
[http://dx.doi.org/10.1186/s13550-018-0419-z] [PMID: 30006851]
[28]
Willowson, K.P.; Hayes, A.R.; Chan, D.L.H.; Tapner, M.; Bernard, E.J.; Maher, R.; Pavlakis, N.; Clarke, S.J.; Bailey, D.L. Clinical and imaging-based prognostic factors in radioembolisation of liver metastases from colorectal cancer: A retrospective exploratory analysis. EJNMMI Res., 2017, 7(1), 46.
[http://dx.doi.org/10.1186/s13550-017-0292-1] [PMID: 28536968]
[29]
Kao, Y.H.; Steinberg, J.D.; Tay, Y.S.; Lim, G.K.Y.; Yan, J.; Townsend, D.W.; Budgeon, C.A.; Boucek, J.A.; Francis, R.J.; Cheo, T.S.T.; Burgmans, M.C.; Irani, F.G.; Lo, R.H.G.; Tay, K.H.; Tan, B.S.; Chow, P.K.H.; Satchithanantham, S.; Tan, A.E.H.; Ng, D.C.E.; Goh, A.S.W. Post-radioembolization yttrium-90 PET/CT - part 2: Dose-response and tumor predictive dosimetry for resin microspheres. EJNMMI Res., 2013, 3(1), 57.
[http://dx.doi.org/10.1186/2191-219X-3-57] [PMID: 23885971]
[30]
Garin, E.; Rolland, Y.; Laffont, S.; Edeline, J. Clinical impact of 99mTc-MAA SPECT/CT-based dosimetry in the radioembolization of liver malignancies with 90Y-loaded microspheres. Eur. J. Nucl. Med. Mol. Imaging, 2016, 43(3), 559-575.
[http://dx.doi.org/10.1007/s00259-015-3157-8] [PMID: 26338177]
[31]
Garin, E.; Rolland, Y.; Pracht, M.; Le Sourd, S.; Laffont, S.; Mesbah, H.; Haumont, L.A.; Lenoir, L.; Rohou, T.; Brun, V.; Edeline, J. High impact of macroaggregated albumin-based tumour dose on response and overall survival in hepatocellular carcinoma patients treated with 90Y-loaded glass microsphere radioembolization. Liver Int., 2017, 37(1), 101-110.
[http://dx.doi.org/10.1111/liv.13220]
[32]
Richetta, E.; Pasquino, M.; Poli, M.; Cutaia, C.; Valero, C.; Tabone, M.; Paradisi, B.P.; Pacilio, M.; Pellerito, R.E.; Stasi, M. PET-CT post therapy dosimetry in radioembolization with resin 90Y microspheres: Comparison with pre-treatment SPECT-CT 99mTc-MAA results. Phys. Med., 2019, 64, 16-23.
[http://dx.doi.org/10.1016/j.ejmp.2019.05.025] [PMID: 31515015]
[33]
Jadoul, A.; Bernard, C.; Lovinfosse, P.; Gérard, L.; Lilet, H.; Cornet, O.; Hustinx, R. Comparative dosimetry between 99mTc-MAA SPECT/CT and 90Y PET/CT in primary and metastatic liver tumors. Eur. J. Nucl. Med. Mol. Imaging, 2020, 47(4), 828-837.
[http://dx.doi.org/10.1007/s00259-019-04465-7] [PMID: 31388721]

Rights & Permissions Print Cite
Article Metrics
24
2
Wayfinder Image
© 2024 Bentham Science Publishers | Privacy Policy