Dosimetric Development of Yttrium-90 Resin Microspheres for Selective Internal Radiation Therapy: Current Status and Perspectives

Abstract

Yttrium-90 resin microspheres selective internal radiation therapy (${}^{90}$Y-SIRT) has been increasingly adopted worldwide as a locoregional treatment option for appropriately selected patients with liver malignancies. The key to ensuring that the tumor receives an adequate radiation dose while minimizing the dose to normal tissues is to optimize the trade-off between tumor control and the probability of normal tissue complications. To accurately determine a patient's internal radiation dose, pre-treatment dose planning and post-treatment dose verification using dosimetric methods are recommended and increasingly considered best practice in ${}^{90}$Y-SIRT, where feasible. Due to the increased demand for personalized treatment and dose accuracy in clinical practice, ${}^{90}$Y-SIRT dosimetry has transitioned from organ-level to voxel-level dosimetry. This paper introduces the relevant principles and development history of ${}^{90}$Y-SIRT dosimetry for resin microspheres. It also discusses the clinical performance, influencing factors and practical applications of relevant dosimetry methods. These include body surface area (BSA) method, MIRD multi-compartment model method, and partition model method; voxel-S-value (VSV); local deposition method (LDM); and Monte Carlo (MC) method. Finally, it covers the subsequent development of resin microsphere ${}^{90}$Y-SIRT dosimetry.