Simultaneous 166 Ho/99m Tc dual-isotope SPECT with Monte Carlo-based downscatter correction for automatic liver dosimetry in radioembolization

EJNMMI Physics
Rob van RooijMarnix G E H Lam

Abstract

Intrahepatic dosimetry is paramount to optimize radioembolization treatment accuracy using radioactive holmium-166 microspheres (166Ho). This requires a practical protocol that combines quantitative imaging of microsphere distribution with automated and robust delineation of the volumes of interest. To this end, we propose a dual isotope single photon emission computed tomography (SPECT) protocol based on 166Ho therapeutic microspheres and technetium-99 m (99mTc) stannous phytate, which accumulates in healthy liver tissue. This protocol may allow accurate and automatic estimation of tumor-absorbed dose and healthy liver-absorbed dose. The current study focuses on a Monte Carlo-based reconstruction framework that inherently corrects for scatter crosstalk between the 166Ho and 99mTc imaging. To demonstrate the feasibility of the method, it is evaluated with realistic phantom experiments and patient data. The Utrecht Monte Carlo System (UMCS) was extended to include detailed modeling of crosstalk interactions between 99mTc and 166Ho. First, 99mTc images were reconstructed including energy window-based corrections for 166Ho downscatter. Next, 99mTc downscatter in the 81-keV 166Ho window was Monte Carlo simulated to allow quantitati...Continue Reading

References

Dec 11, 2013·Medical Physics·Mattijs ElschotHugo W A M de Jong
May 14, 2014·European Journal of Nuclear Medicine and Molecular Imaging·Mattijs ElschotHugo W A M de Jong
Apr 29, 2015·European Journal of Nuclear Medicine and Molecular Imaging·Marnix G E H LamDaniel Y Sze
Feb 26, 2016·Journal of Nuclear Medicine : Official Publication, Society of Nuclear Medicine·Andor van den HovenMarnix Lam
Sep 17, 2017·Journal of Nuclear Medicine : Official Publication, Society of Nuclear Medicine·Jip F PrinceMarnix G E H Lam
Dec 7, 2017·The Lancet Oncology·Arthur J A T BraatMarnix G E H Lam
Feb 8, 2018·The Lancet Oncology·Etienne GarinJulien Edeline

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Citations

Dec 5, 2020·Clinical Oncology : a Journal of the Royal College of Radiologists·J Buscombe

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Software Mentioned

UMCS
OSEM Monte Carlo System
MCNP

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