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Single-Compartment Dose Prescriptions for Ablative 90Y-Radioembolization Segmentectomy.
Srinivas Cheenu Kappadath1, Benjamin P Lopez1
1Department of Imaging Physics, UT MD Anderson Cancer Center, 1155 Pressler St., Unit 1352, Houston, TX 77030, USA.
Life (Basel, Switzerland)
|June 28, 2023
Summary
This study developed a dosimetry model for Yttrium-90 radioembolization, estimating doses needed for complete pathologic necrosis (CPN). The findings provide essential dose metrics for optimizing treatment and achieving tumor ablation.
Area of Science:
- Medical Physics
- Radiology
- Oncology
Background:
- Yttrium-90 (90Y) radioembolization is a curative treatment for tumors.
- Previous studies reported single-compartment doses for complete pathologic necrosis (CPN).
- Actual delivered doses to tumors and margins for CPN remain unquantified.
Purpose of the Study:
- To present an ablative dosimetry model for Yttrium-90 radioembolization.
- To estimate dose distributions for tumors and at-risk margins.
- To identify necessary dose metrics for achieving CPN.
Main Methods:
- Modeled 3D activity distributions of spherical tumors.
- Estimated 3D dose distributions using a 90Y dose kernel.
- Calculated voxel-based mean tumor dose, rim dose, and 2mm margin dose based on clinical CPN data.
Main Results:
- Established voxel-level doses for CPN: 1053 Gy (mean tumor), 860 Gy (tumor boundary), 561 Gy (2mm margin).
- Nominal case: 2.5 cm tumor, T:N ratio 3:1, treated with 400 Gy segmental dose.
- Tabulated segmental doses for various tumor sizes and uptake ratios.
Conclusions:
- Reported analytical functions for CPN dose metrics.
- Provided single-compartment dose prescriptions for achieving CPN.
- Covered tumor diameters from 1-7 cm and T:N ratios from 2:1-5:1.
