Open Access90 Y SPECT / CT quantitative study and comparison of uptake with pretreatment 99 m Tc‐ MAA SPECT / CT in radiomicrosphere therapy
Author(s) -
Debebe Senait Aknaw,
Adjouadi Malek,
Gulec Seza A.,
Franquiz Juan,
McGoron Anthony J.
Publication year - 2019
Publication title -
journal of applied clinical medical physics
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.83
H-Index - 48
ISSN - 1526-9914
DOI - 10.1002/acm2.12512
Subject(s) - nuclear medicine , single photon emission computed tomography , dosimetry , spect imaging , absorbed dose , imaging phantom , radionuclide therapy , bremsstrahlung , biodistribution , medicine , physics , chemistry , photon , optics , biochemistry , in vitro
Yttrium‐90 ( 90 Y) microsphere post‐treatment imaging reflects the true distribution characteristics of microspheres in the tumor and liver compartments. However, due to its decay spectra profile lacking a pronounced photopeak, the bremsstrahlung imaging for 90 Y has inherent limitations. The absorbed dose calculations for 90 Y microspheres radiomicrosphere therapy ( RMT ) sustain a limitation due to the poor quality of 90 Y imaging. The aim of this study was to develop quantitative methods to improve the post‐treatment 90 Y bremsstrahlung single photon emission tomography (SPECT)/computed tomography (CT) image analysis for dosimetric purposes and to perform a quantitative comparison with the 99m Tc‐ MAA SPECT / CT images, which is used for theranostics purposes for liver and tumor dosimetry. Methods Pre and post‐treatment SPECT / CT data of patients who underwent RMT for primary or metastatic liver cancer were acquired. A Jasczak phantom with eight spherical inserts of various sizes was used to obtain optimal iteration number for the contrast recovery algorithm for improving 90 Y bremsstrahlung SPECT / CT images. Comparison of uptake on 99m Tc‐ MAA and 90 Y microsphere SPECT / CT images was assessed using tumor to healthy liver ratios ( TLR s). The voxel dosimetry technique was used to estimate absorbed doses. Absorbed doses within the tumor and healthy part of the liver were also investigated for correlation with administered activity. Results Improvement in CNR and contrast recovery coefficients on patient and phantom 90 Y bremsstrahlung SPECT / CT images respectively were achieved. The 99m Tc‐ MAA and 90 Y microspheres SPECT / CT images showed significant uptake correlation ( r = 0.9, P = 0.05) with mean TLR of 9.4 ± 9.2 and 5.0 ± 2.2, respectively. The correlation between the administered activity and tumor absorbed dose was weak ( r = 0.5, P > 0.05), however, healthy liver absorbed dose increased with administered activity ( r = 0.8, P = 0.0). Conclusions This study demonstrated correlation in mean TLR between 99m Tc‐ MAA and 90 Y microsphere SPECT / CT .