RT Journal Article
SR Electronic
T1 Partition Model–Based <sup>99m</sup>Tc-MAA SPECT/CT Predictive Dosimetry Compared with <sup>90</sup>Y TOF PET/CT Posttreatment Dosimetry in Radioembolization of Hepatocellular Carcinoma: A Quantitative Agreement Comparison
JF Journal of Nuclear Medicine
JO J Nucl Med
FD Society of Nuclear Medicine
SP 1672
OP 1678
DO 10.2967/jnumed.116.173104
VO 57
IS 11
A1 Gnesin, Silvano
A1 Canetti, Laurent
A1 Adib, Salim
A1 Cherbuin, Nicolas
A1 Silva Monteiro, Marina
A1 Bize, Pierre
A1 Denys, Alban
A1 Prior, John O.
A1 Baechler, Sebastien
A1 Boubaker, Ariane
YR 2016
UL http://jnm.snmjournals.org/content/57/11/1672.abstract
AB 90Y-microsphere selective internal radiation therapy (SIRT) is a valuable treatment in unresectable hepatocellular carcinoma (HCC). Partition-model predictive dosimetry relies on differential tumor-to-nontumor perfusion evaluated on pretreatment 99mTc-macroaggregated albumin (MAA) SPECT/CT. The aim of this study was to evaluate agreement between the predictive dosimetry of 99mTc-MAA SPECT/CT and posttreatment dosimetry based on 90Y time-of-flight (TOF) PET/CT. Methods: We compared the 99mTc-MAA SPECT/CT results for 27 treatment sessions (25 HCC patients, 41 tumors) with 90Y SIRT (7 glass spheres, 20 resin spheres) and the posttreatment 90Y TOF PET/CT results. Three-dimensional voxelized dose maps were computed from the 99mTc-MAA SPECT/CT and 90Y TOF PET/CT data. Mean absorbed dose () was evaluated to compute the predicted-to-actual dose ratio () in tumor volumes (TVs) and nontumor volumes (NTVs) for glass and resin spheres. The Lin concordance () was used to measure accuracy () and precision (ρ). Results: Administered activity ranged from 0.8 to 1.9 GBq for glass spheres and from 0.6 to 3.4 GBq for resin spheres, and the respective TVs ranged from 2 to 125 mL and from 6 to 1,828 mL. The mean dose was 240 Gy for glass and 122 Gy for resin in TVs and 72 Gy for glass and 47 Gy for resin in NTVs. was 1.46 ± 0.58 (0.65–2.53) for glass and 1.16 ± 0.41 (0.54–2.54) for resin, and the respective values for were 0.88 ± 0.15 (0.56–1.00) and 0.86 ± 0.2 (0.58–1.35). DR variability was substantially lower in NTVs than in TVs. The Lin concordance between and (resin) was significantly better for tumors larger than 150 mL than for tumors 150 mL or smaller ( = 0.93 and = 0.95 vs. = 0.57 and = 0.93; P &lt; 0.05). Conclusion: In 90Y radioembolization of HCC, predictive dosimetry based on 99mTc-MAA SPECT/CT provided good estimates of absorbed doses calculated from posttreatment 90Y TOF PET/CT for tumor and nontumor tissues. The low variability of demonstrates that pretreatment dosimetry is particularly suitable for minimizing radiation-induced hepatotoxicity.