Rapid predictive dosimetry for radioembolization

Document Type : Technical note

Author

Department of Nuclear Medicine, The Royal Melbourne Hospital, Victoria, Australia

Abstract

Economics of today’s busy clinical practice demand both time and cost-efficient methods of predictive dosimetry for liver radioembolisation. A rapid predictive schema adapted from the Medical Internal Radiation Dose (MIRD) method i.e., Partition Model, has been devised that can be completed within minutes. This rapid schema may guide institutions that do not have access to software capable of comprehensive auto-segmentation of lung, tumour and non-tumorous liver, or where rigorous artery-specific tomographic predictive dosimetry is unfeasible for the routine clinical workflow. This rapid schema is applicable to any beta-emitting radiomicrosphere, although absorbed dose-response thresholds will differ according to device. Sampling errors in lung, tumour and non-tumorous liver will compound and propagate throughout this schema. This rapid schema achieves efficiency in lieu of accuracy. The user must be mindful of potentially large sampling errors and assumes all responsibility. Any suspicion of significant error requires the user to revert back to standard-of-care methods.

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  1. Kao YH, Hock Tan AE, Burgmans MC, Irani FG, Khoo LS, Gong Lo RH, et al. Image-guided personalized predictive dosimetry by artery-specific SPECT/CT partition modeling for safe and effective 90Y radioembolization. J Nucl Med. 2012; 53: 559-566.
  2. Ho S, Lau WY, Leung TW, Chan M, Ngar YK, Johnson PJ, et al. Partition model for estimating radiation doses from yttrium-90 microspheres in treating hepatic tumours. Eur J Nucl Med. 1996; 23:947-952.
  3. Kao YH, Magsombol BM, Toh Y, Tay KH, Chow PKH, Goh AS, et al. Personalized predictive lung dosimetry by technetium-99m macroaggregated albumin SPECT/CT for yttrium-90 radioembolization. EJNMMI Res. 2014; 4:33.
  4. Kao YH. Dosimetric theory for tumor-to-lung shunt fraction calculation in yttrium-90 radioembolization of noncirrhotic livers. Nucl Med Commun. 2014; 35:331-332.
  5. Kao YH. First Strike personalized predictive radioiodine prescription for inoperable metastatic differentiated thyroid cancer. Asia Ocean J Nucl Med Biol. 2023; 11:158-167.