Phantom validation of quantitative Y-90 PET/CT-based dosimetry in liver radioembolization

Marco D’Arienzo, Maria Pimpinella, Marco Capogni, Vanessa De Coste, Luca Filippi, Emiliano Spezi, Nick Patterson, Francesca Mariotti, Paolo Ferrari, Paola Chiaramida, Michael Tapner, Alexander Fischer, Timo Paulus, Roberto Pani, Giuseppe Iaccarino, Marco D’Andrea, Lidia Strigari, Oreste Bagni

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Background: PET/CT has recently been shown to be a viable alternative to traditional post-infusion imaging methods providing good quality images of90Y-laden microspheres after selective internal radiation therapy (SIRT). In the present paper, first we assessed the quantitative accuracy of90Y-PET using an anthropomorphic phantom provided with lungs, liver, spine, and a cylindrical homemade lesion located into the hepatic compartment. Then, we explored the accuracy of different computational approaches on dose calculation, including (I) direct Monte Carlo radiation transport using Raydose, (II) Kernel convolution using Philips Stratos, (III) local deposition algorithm, (IV) Monte Carlo technique (MCNP) considering a uniform activity distribution, and (V) MIRD (Medical Internal Radiation Dose) analytical approach. Finally, calculated absorbed doses were compared with those obtained performing measurements with LiF:Mg,Cu,P TLD chips in a liquid environment. Results: Our results indicate that despite90Y-PET being likely to provide high-resolution images, the90Y low branch ratio, along with other image-degrading factors, may produce non-uniform activity maps, even in the presence of uniform activity. A systematic underestimation of the recovered activity, both for the tumor insert and for the liver background, was found. This is particularly true if no partial volume correction is applied through recovery coefficients. All dose algorithms performed well, the worst case scenario providing an agreement between absorbed dose evaluations within 20%. Average absorbed doses determined with the local deposition method are in excellent agreement with those obtained using the MIRD and the kernel-convolution dose calculation approach. Finally, absorbed dose assessed with MC codes are in good agreement with those obtained using TLD in liquid solution, thus confirming the soundness of both calculation approaches. This is especially true for Raydose, which provided an absorbed dose value within 3% of the measured dose, well within the stated uncertainties. Conclusions: Patient-specific dosimetry is possible even in a scenario with low true coincidences and high random fraction, as in90Y–PET imaging, granted that accurate absolute PET calibration is performed and acquisition times are sufficiently long. Despite Monte Carlo calculations seeming to outperform all dose estimation algorithms, our data provide a strong argument for encouraging the use of the local deposition algorithm for routine90Y dosimetry based on PET/CT imaging, due to its simplicity of implementation.
Original languageEnglish
Article number94
Pages (from-to)-
JournalEJNMMI Research
Publication statusPublished - 2017
Externally publishedYes


All Science Journal Classification (ASJC) codes

  • Radiology Nuclear Medicine and imaging

Cite this

D’Arienzo, M., Pimpinella, M., Capogni, M., De Coste, V., Filippi, L., Spezi, E., Patterson, N., Mariotti, F., Ferrari, P., Chiaramida, P., Tapner, M., Fischer, A., Paulus, T., Pani, R., Iaccarino, G., D’Andrea, M., Strigari, L., & Bagni, O. (2017). Phantom validation of quantitative Y-90 PET/CT-based dosimetry in liver radioembolization. EJNMMI Research, 7, -. [94].