MIDOS: a novel stochastic model towards a treatment planning system for microsphere dosimetry in liver tumors.
Purpose: Transarterial radioembolization (TARE) procedures treat liver tumors by injecting radioactive microspheres into the hepatic artery. Currently, there is a critical need to optimize TARE towards a personalized dosimetry approach. To this aim, we present a novel microsphere dosimetry (MIDOS) s...
| Published in: | European Journal of Nuclear Medicine & Molecular Imaging Vol. 51; no. 6; pp. 1506 - 1516 |
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| Main Authors: | , , , , , , , |
| Format: | Journal Article |
| Published: |
Springer Nature
May2024
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| Online Access: | View this record in EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=176804760&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 176804760 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 16197070 NPC jtl: European Journal of Nuclear Medicine & Molecular Imaging issn: 16197070 maglogo: N pubinfo: dt: May2024 vid: 51 iid: 6 pid: 237 pub: Springer Nature place: New York, New York artinfo: ui: 176804760 174518736 10.1007/s00259-023-06567-9 176804760 ppf: 1506 ppct: 10 formats: fmt: – @attributes: type: T – @attributes: type: P tig: atl: MIDOS: a novel stochastic model towards a treatment planning system for microsphere dosimetry in liver tumors. aug: au: Huesa-Berral, Carlos Withrow, Julia D. Dawson, Robert J. Beekman, Chris Bolch, Wesley E. Paganetti, Harald Wehrenberg-Klee, Eric Bertolet, Alejandro affil: https://ror.org/002pd6e78 Department of Radiation Oncology, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA sug: ab: Purpose: Transarterial radioembolization (TARE) procedures treat liver tumors by injecting radioactive microspheres into the hepatic artery. Currently, there is a critical need to optimize TARE towards a personalized dosimetry approach. To this aim, we present a novel microsphere dosimetry (MIDOS) stochastic model to estimate the activity delivered to the tumor(s), normal liver, and lung. Methods: MIDOS incorporates adult male/female liver computational phantoms with the hepatic arterial, hepatic portal venous, and hepatic venous vascular trees. Tumors can be placed in both models at user discretion. The perfusion of microspheres follows cluster patterns, and a Markov chain approach was applied to microsphere navigation, with the terminal location of microspheres determined to be in either normal hepatic parenchyma, hepatic tumor, or lung. A tumor uptake model was implemented to determine if microspheres get lodged in the tumor, and a probability was included in determining the shunt of microspheres to the lung. A sensitivity analysis of the model parameters was performed, and radiation segmentectomy/lobectomy procedures were simulated over a wide range of activity perfused. Then, the impact of using different microspheres, i.e., SIR-Sphere®, TheraSphere®, and QuiremSphere®, on the tumor-to-normal ratio (TNR), lung shunt fraction (LSF), and mean absorbed dose was analyzed. Results: Highly vascularized tumors translated into increased TNR. Treatment results (TNR and LSF) were significantly more variable for microspheres with high particle load. In our scenarios with 1.5 GBq perfusion, TNR was maximum for TheraSphere® at calibration time in segmentectomy/lobar technique, for SIR-Sphere® at 1–3 days post-calibration, and regarding QuiremSphere® at 3 days post-calibration. Conclusion: This novel approach is a decisive step towards developing a personalized dosimetry framework for TARE. MIDOS assists in making clinical decisions in TARE treatment planning by assessing various delivery parameters and simulating different tumor uptakes. MIDOS offers evaluation of treatment outcomes, such as TNR and LSF, and quantitative scenario-specific decisions. pubtype: Academic Journal doctype: Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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