The Impact of Image Reconstruction Parameters on TARE Treatment Dosimetric Calculation

Öz

Accurate dosimetric calculations are essential to enhance therapeutic efficacy in Yttrium-90 (Y-90) microsphere therapy, which rely significantly on the three-dimensional imaging parameters used. This study aims to evaluate the reconstruction parameters used to generate three-dimensional images from SPECT data obtained for dosimetric calculations, and to determine the optimal reconstruction parameters. This retrospective study evaluated Single Photon Emission Computed Tomography/Computed Tomography (SPECT/CT) images of 30 patients (8 women and 22 men) who underwent Transarterial Radioembolization (TARE) treatment at our clinic between 2018 and 2019 using Technetium 99mTc-labeled macroaggregated albumin (99mTc-MAA). The SPECT images were reconstructed using 20 different iterations and subset values. The perfused areas were identified using 5% and 10% threshold values. At the 5% threshold, the maximum difference from the average was 20.7% at 2 iterations and 2 subsets. For other parameters, the difference from the average was less than 2.8%. At the 10% threshold, the maximum difference from the average was 14.8% at 2 iterations and 2 subsets, with other parameters again showing a difference of less than 2.8%. For effective TARE treatment, it is recommended to set the SPECT image reconstruction parameters to higher than 5 iterations and 5 subsets following the administration of 99mTc-MAA.

Anahtar Kelimeler

• Dosimetry
• Iteration
• Subset
• Radioembolization
• SPECT

Kaynakça

1. [1]. Lam M, Garin E, et al. A global evaluation of advanced dosimetry in transarterial radioembolization of hepatocellular carcinoma with Yttrium-90: the TARGET study. European Journal of Nuclear Medicine and Molecular Imaging. 2022;49:3340-52.
2. [2]. Ramdhani K, Braat A. The Evolving Role of Radioembolization in the Treatment of Neuroendocrine Liver Metastases. Cancers. 2022;14.
3. [3] Mikell JK, Dewaraja YK, et al. Transarterial Radioembolization for Hepatocellular Carcinoma and Hepatic Metastases: Clinical Aspects and Dosimetry Models. Seminars in radiation oncology. 2020;30:68-76.
4. [4] Weber M, Lam M, et al. EANM procedure guideline for the treatment of liver cancer and liver metastases with intra-arterial radioactive compounds. European Journal of Nuclear Medicine and Molecular Imaging. 2022;49:1682-99.
5. [5] Kovan B, Civan C, et al. Influencing factors of lung shunt fraction in transarterial radioembolization treatment. Clinical and Translational Imaging. 2024, 12.2: 205-211.
6. [6] Yilmaz E, Engin MN, et al. Y90 selective internal radiation therapy and peptide receptor radionuclide therapy for the treatment of metastatic neuroendocrine tumors: combination or not? Nuclear Medicine Communications. 2020;41:1242-9.
7. [7] Abuqbeitah M, Demir M. Effect of predicted lung mass versus fixed mass regimes on lung dose in SIRT (90Y). International Journal of Computational and Experimental Science and Engineering. 2024;10.
8. [8] Kovan B, Denizmen D, et al. Influence of Early Versus Delayed Hepatic Artery Perfusion Scan on (90)Y Selective Internal Radiation Therapy Planning. Cancer Biotherapy and Radiopharmaceuticals. 2024.

9. [9] Guiu B, Garin E, et al. TARE in Hepatocellular Carcinoma: From the Right to the Left of BCLC. Cardiovascular Interventional Radiology. 2022;45:1599-607.
10. [10] Busse NC, Al‐Ghazi MS, et al. AAPM Medical Physics Practice Guideline 14. a: Yttrium‐90 microsphere radioembolization. Journal of Applied Clinical Medical Physics. 2024;25:e14157.
11. [11] Dezarn WA, Cessna JT, et al. Recommendations of the American Association of Physicists in Medicine on dosimetry, imaging, and quality assurance procedures for 90Y microsphere brachytherapy in the treatment of hepatic malignancies. Medical Physics. 2011;38:4824-45.
12. [12] Chiesa C, Sjogreen-Gleisner K, et al. EANM dosimetry committee series on standard operational procedures: a unified methodology for (99m)Tc-MAA pre- and (90)Y peri-therapy dosimetry in liver radioembolization with (90)Y microspheres. EJNMMI Physics. 2021;8:77.
13. [13] Marquis H, Ocampo Ramos JC, et al. MIRD Pamphlet No. 29: MIRDy90-A (90)Y Research Microsphere Dosimetry Tool. Journal of Nuclear Medicine. 2024.
14. [14] Linder PM, Lan W, et al. Optimization of Y-90 Radioembolization Imaging for Post-Treatment Dosimetry on a Long Axial Field-of-View PET/CT Scanner. Diagnostics. 2023;13.
15. [15] Costa G, Spencer B, et al. Radioembolization Dosimetry with Total-Body (90)Y PET. Journal of Nuclear Medicine. 2022;63:1101-7.
16. [16] Kappadath SC. Effects of voxel size and iterative reconstruction parameters on the spatial resolution of 99mTc SPECT/CT. Journal of Applied Clinical Medical Physics. 2011;12:3459.
17. [17] Orcajo Rincón J, Regi AR, et al., "Maximum tumor-absorbed dose measured by voxel-based multicompartmental dosimetry as a response predictor in yttrium-90 radiation segmentectomy for hepatocellular carcinoma," (in eng), EJNMMI Physics, vol. 10, no. 1, p. 7, Feb 6 2023, doi: 10.1186/s40658-022-00520-9.
18. [18] Villalobos A, Arndt L, et al., "Yttrium-90 Radiation Segmentectomy of Hepatocellular Carcinoma: A Comparative Study of the Effectiveness, Safety, and Dosimetry of Glass-Based versus Resin-Based Microspheres," (in eng), Journal of Vascular and Interventional Radiology, vol. 34, no. 7, pp. 1226-1234, Jul 2023, doi: 10.1016/j.jvir.2023.02.030.
19. [19] Yoo M. Y, Paeng JC, et al., "Efficacy of voxel-based dosimetry map for predicting response to trans-arterial radioembolization therapy for hepatocellular carcinoma: a pilot study," (in eng), Nuclear Medicine Communications, vol. 42, no. 12, pp. 1396-1403, Dec 1 2021, doi: 10.1097/mnm.0000000000001471.
20. [20] Coskun N, Kartal MO, et al., "Use of dose-volume histograms for metabolic response prediction in hepatocellular carcinoma patients undergoing transarterial radioembolization with Y-90 resin microspheres," (in eng), Annals of Nuclear Medicine, Apr 22 2024, doi: 10.1007/s12149-024-01926-4.