This supports the implementation of (90)Y PET in selective internal radiation therapy of the liver.
The aim of this study is to determine the feasibility of achieving quantitative measurement in (90)Y-microspheres liver selective internal radiotherapy (SIRT) by imaging (90)Y with a conventional non-time of flight (TOF) PET device. Instead of the bremsstrahlung x-rays of the β-decay, the low branch of e(-)- e(+) pair production in the (90)Y-decay was used. The activity distribution in a phantom-simulated liver SIRT was obtained by direct (90)Y-PET imaging. We tested a LYSO TOF PET and two GSO and BGO non-TOF PET scanners using a 3.6-l cylindrical phantom filled with the (90)Y solution containing two sets of hot and cold spheres. The best hot contrast was obtained with the LYSO TOF. It was close to the expected value and remained constant, even for short acquisition times. The LYSO non-TOF was about 10% lower. The GSO performed similarly but degraded for shorter times whilst the BGO was the worst with 40% loss. For the cold spheres, the LYSO TOF and the GSO provided the best results, while the LYSO non-TOF and the BGO were the worst. (90)Y PET imaging in liver SIRT is achievable with LYSO TOF. Conventional LYSO and GSO show a loss of contrast and require longer acquisition times. BGO imaging is not feasible for dosimetry calculation.
Accurate dosimetry in 90 Y peptide receptor radionuclide therapy (PRRT) helps to optimize the injected activity, to prevent kidney or red marrow toxicity, while giving the highest absorbed dose to tumors. The aim of this study was to evaluate whether direct 90 Y bismuth germanate or lutetium yttrium orthosilicate time-of-flight PET was accurate enough to provide dosimetry estimates suitable to 90 Y PRRT. Method: To overcome the statistical uncertainty arising from the low 90 Y positron counting rate, the computation of the cortex mean-absorbed dose was divided into 4 steps: delineation of the cortex volume of interest (VOI) on the CT scan, determination of the recovery coefficient from the cortex VOI using the point-spread function of the whole imaging process, determination of the mean cortex-absorbed dose per unit cumulated activity in the cortex (S cortex)cortex value) from the cortex VOI using a 90 Y voxel S value kernel, and determination of the number of decays in the cortex VOI from the PET reconstruction. Our 4-step method was evaluated using an anthropomorphic abdominal phantom containing a fillable kidney phantom based on the MIRD kidney model. Vertebrae with an attenuation similar to that of bone were also modeled. Two tumors were modeled by 7-mL hollow acrylic spheres and the spleen by a plastic bag. Activities corresponded to typical tissue uptake in a first 90 Y-DOTATOC cycle of 4.4 GBq, considered as free of significant renal toxicity. Eight successive 45-min scans were acquired on both systems. Results: Both PET systems were successful in determining absorbed dose to modeled tumors but failed to provide accurate red marrow dosimetry. Renal cortex dosimetry was reproducible for both PET systems, with an accuracy of 3% for the bismuth germanate system but only 18% for the lutetium yttrium orthosilicate time-of-flight system, which was hindered by the natural radioactivity of the crystal, especially in the most attenuated area of the kidney. Conclusion: This study supports the use of direct 90 Y PET of the first PRRT cycle to assess the kidney-absorbed dose and optimize the injected activity of the following cycles.Key Words: PET/CT; radiobiology/dosimetry; radionuclide therapy; PET; PRRT; dosimetry; kidney; 90 Y J Nucl Med 2010; 51:1969 51: -1973 51: DOI: 10.2967 Pept ide receptor radionuclide therapy (PRRT) with 90 Y is widely used for internal radiotherapy of neuroendocrine tumors (1). 90 Y has a long b 2 range that, although suboptimal for small tumors, irradiates rather uniformly larger tumors that often display heterogeneous perfusion. This irradiation ability was confirmed in an animal model, in which a combination of 90 Y-and 177 Lu-labeled somatostatin analog showed a better tumor response than either radioisotope alone (2). Used alone, 90 Y PRRT is frequently administrated in several cycles. The dose fractionation has proven less toxic for the kidney (3) because it allows DNA repair in normal tissues between cycles, without a noticeable reduction of the tumor response (4).Assessment of...
An approximate analytical solution of the problem of attenuation and distancedependent resolution effects in single photon emission tomography is presented for the case of B uniform absorbing medium. The algorithm oblained is a generalization of the Bellini and m-workers formula correcting for the single attenuation effect and is derived by means of Fourier tramforms only. The method has been validated on mathematical phantoms ar well as on physical data
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