Discordance between 90Y-PET/CT(MR)-estimated activity and dose calibrator measured administered activity: an international study in SIRT patients treated with resin and glass microspheres.
IF 3 2区 医学Q2 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING
Thomas Carlier, Silvano Gnesin, Justin K Mikell, Maurizio Conti, John O Prior, Niklaus Schaefer, Maria Del Sol Pérez Lago, Clément Bailly, Yuni K Dewaraja, Thiago V M Lima
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引用次数: 0
Abstract
Purpose: Therapeutic administration of 90Y-loaded microspheres is routinely used for primary and secondary liver tumours. For activity-based therapeutic prescription the activity must be within 10% of the intended activity. Previous studies reported significant discrepancies between manufacturer-declared vial activities and both experimental and Monte-Carlo assessments, greater than 10%, for resin/glass 90Y-microspheres. The objective of this work was to investigate whether these discrepancies were also seen in patients.
Methods: We analysed patient 90Y-PET reconstructions (99 glass and 15 resin microspheres) from 4 different institutions and 4 different systems. We considered tail-fitting background scaling (TFBS) and absolute scaling (ABS), for scatter correction. Residuals after therapeutic injection were measured. Eighty-one patients were imaged with PET/CT and 33 with PET/MR. The PET measured activity (APET) was assessed in the whole liver. The ratio APET/Acalibrator was calculated for each patient, where Acalibrator was the injected activity measured by the dose calibrator corrected for residual and lung shunt.
Results: Quantification ratio between calibrators and PET was significantly different from 1, regardless of the scatter correction used. In glass microspheres, the mean APET/CT/Acalibrator was 0.84 ± 0.06 for TFBS and 0.90 ± 0.06 for ABS (0.66 ± 0.09 and 0.76 ± 0.07 for (APET/MR/Acalibrator)). The mean APET/CT/Acalibrator ratio for resin microspheres was 1.16 ± 0.09 for TFBS and 1.30 ± 0.12 for ABS.
Conclusions: We observed in patients similar activity discrepancies as reported for vials, with a relative difference of 44 ± 16% between glass and resin 90Y-loaded microspheres. In 90Y hepatic radioembolization, the 10% accuracy prerequisite on knowing the administered therapeutic activity is then unlikely to be met.
期刊介绍：
EJNMMI Physics is an international platform for scientists, users and adopters of nuclear medicine with a particular interest in physics matters. As a companion journal to the European Journal of Nuclear Medicine and Molecular Imaging, this journal has a multi-disciplinary approach and welcomes original materials and studies with a focus on applied physics and mathematics as well as imaging systems engineering and prototyping in nuclear medicine. This includes physics-driven approaches or algorithms supported by physics that foster early clinical adoption of nuclear medicine imaging and therapy.
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