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
{"title":"90Y-PET/CT(MR)估计活性与剂量校准器测量的给药活性之间的不一致性：一项针对使用树脂和玻璃微球治疗 SIRT 患者的国际研究。","authors":"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","doi":"10.1186/s40658-025-00725-8","DOIUrl":null,"url":null,"abstract":"<p><strong>Purpose: </strong>Therapeutic administration of <sup>90</sup>Y-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 <sup>90</sup>Y-microspheres. The objective of this work was to investigate whether these discrepancies were also seen in patients.</p><p><strong>Methods: </strong>We analysed patient <sup>90</sup>Y-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 (A<sub>PET</sub>) was assessed in the whole liver. The ratio A<sub>PET</sub>/A<sub>calibrator</sub> was calculated for each patient, where A<sub>calibrator</sub> was the injected activity measured by the dose calibrator corrected for residual and lung shunt.</p><p><strong>Results: </strong>Quantification ratio between calibrators and PET was significantly different from 1, regardless of the scatter correction used. In glass microspheres, the mean A<sub>PET/CT</sub>/A<sub>calibrator</sub> was 0.84 ± 0.06 for TFBS and 0.90 ± 0.06 for ABS (0.66 ± 0.09 and 0.76 ± 0.07 for (A<sub>PET/MR</sub>/A<sub>calibrator</sub>)). The mean A<sub>PET/CT</sub>/A<sub>calibrator</sub> ratio for resin microspheres was 1.16 ± 0.09 for TFBS and 1.30 ± 0.12 for ABS.</p><p><strong>Conclusions: </strong>We observed in patients similar activity discrepancies as reported for vials, with a relative difference of 44 ± 16% between glass and resin <sup>90</sup>Y-loaded microspheres. In <sup>90</sup>Y hepatic radioembolization, the 10% accuracy prerequisite on knowing the administered therapeutic activity is then unlikely to be met.</p>","PeriodicalId":11559,"journal":{"name":"EJNMMI Physics","volume":"12 1","pages":"12"},"PeriodicalIF":3.0000,"publicationDate":"2025-02-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11799454/pdf/","citationCount":"0","resultStr":"{\"title\":\"Discordance between <sup>90</sup>Y-PET/CT(MR)-estimated activity and dose calibrator measured administered activity: an international study in SIRT patients treated with resin and glass microspheres.\",\"authors\":\"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\",\"doi\":\"10.1186/s40658-025-00725-8\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Purpose: </strong>Therapeutic administration of <sup>90</sup>Y-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 <sup>90</sup>Y-microspheres. The objective of this work was to investigate whether these discrepancies were also seen in patients.</p><p><strong>Methods: </strong>We analysed patient <sup>90</sup>Y-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 (A<sub>PET</sub>) was assessed in the whole liver. The ratio A<sub>PET</sub>/A<sub>calibrator</sub> was calculated for each patient, where A<sub>calibrator</sub> was the injected activity measured by the dose calibrator corrected for residual and lung shunt.</p><p><strong>Results: </strong>Quantification ratio between calibrators and PET was significantly different from 1, regardless of the scatter correction used. In glass microspheres, the mean A<sub>PET/CT</sub>/A<sub>calibrator</sub> was 0.84 ± 0.06 for TFBS and 0.90 ± 0.06 for ABS (0.66 ± 0.09 and 0.76 ± 0.07 for (A<sub>PET/MR</sub>/A<sub>calibrator</sub>)). The mean A<sub>PET/CT</sub>/A<sub>calibrator</sub> ratio for resin microspheres was 1.16 ± 0.09 for TFBS and 1.30 ± 0.12 for ABS.</p><p><strong>Conclusions: </strong>We observed in patients similar activity discrepancies as reported for vials, with a relative difference of 44 ± 16% between glass and resin <sup>90</sup>Y-loaded microspheres. In <sup>90</sup>Y hepatic radioembolization, the 10% accuracy prerequisite on knowing the administered therapeutic activity is then unlikely to be met.</p>\",\"PeriodicalId\":11559,\"journal\":{\"name\":\"EJNMMI Physics\",\"volume\":\"12 1\",\"pages\":\"12\"},\"PeriodicalIF\":3.0000,\"publicationDate\":\"2025-02-05\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11799454/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"EJNMMI Physics\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1186/s40658-025-00725-8\",\"RegionNum\":2,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q2\",\"JCRName\":\"RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"EJNMMI Physics","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1186/s40658-025-00725-8","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING","Score":null,"Total":0}
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.
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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