首页 | 本学科首页   官方微博 | 高级检索  
检索        


Comparison of perfused volume segmentation between cone-beam CT and 99mTc-MAA SPECT/CT for treatment dosimetry before selective internal radiation therapy using 90Y-glass microspheres
Authors:M Martin  A Hocquelet  F Debordeaux  L Bordenave  J-F Blanc  P Papadopoulos  B Lapuyade  H Trillaud  J-B Pinaquy
Institution:1. Department of Radiology, CHU de Bordeaux, CIC1401, 33000 Bordeaux, France;2. Department of Radiology, CHU Vaudois, 1011 Lausanne, Switzerland;3. Department of Nuclear Medicine, CHU de Bordeaux, CIC1401, 33000 Bordeaux, France;4. Université de Bordeaux, INSERM, Bioingénierie tissulaire, U1026, 33000 Bordeaux, France;5. Department of Gastroenterology-Hepatology, hôpital Haut-Lévêque, CHU de Bordeaux, 33000 Bordeaux, France;6. Univ. Bordeaux, Institut de mathématique, MONC, UMR 5251, 33000 Bordeaux, France
Abstract:PurposeTo compare the reliability and accuracy of the pre-treatment dosimetry predictions using cone-beam computed tomography (CBCT) versus 99mTc-labeled macroaggregated albumin (MAA) SPECT/CT for perfused volume segmentation in patients with hepatocellular carcinoma treated by selective internal radiation therapy (SIRT) using 90Y-glass microspheres.Materials and methodsFifteen patients (8 men, 7 women) with a mean age of 68.3 ± 10.5 (SD) years (range: 47–82 years) who underwent a total of 17 SIRT procedures using 90Y-glass microspheres for unresectable hepatocellular carcinoma were retrospectively included. Pre-treatment dosimetry data were calculated from 99mTc-MAA SPECT/CT using either CBCT or 99mTc-MAA SPECT/CT to segment the perfused volumes. Post-treatment dosimetry data were calculated using 90Y imaging (SPECT/CT or PET/CT). The whole liver, non-tumoral liver, and tumor volumes were segmented on CT or MRI data. The mean absorbed doses of the tumor (DT), non-tumoral liver, perfused liver (DPL) and perfused non-tumoral liver were calculated. Intra- and interobserver reliabilities were investigated by calculating Lin's concordant correlation coefficients (ρc values). The differences (biases) between pre- and post-treatment dosimetry data were assessed using the modified Bland–Altman method (for non-normally distributed variables), and systematic bias was evaluated using Passing–Bablok regression.ResultsThe intra- and interobserver reliabilities were good-to-excellent (ρc: 0.80–0.99) for all measures using both methods. Compared with 90Y imaging, the median differences were 5.8 Gy (IQR: ?12.7; 16.1) and 5.6 Gy (IQR: ?13.6; 10.2) for DPL-CBCT and DPL-99mTc-MAA SPECT/CT, respectively. The median differences were 1.6 Gy (IQR: ?29; 7.53) and 9.8 Gy (IQR: ?28.4; 19.9) for DT-CBCT and DT-99mTc-MAA SPECT/CT respectively. Passing–Bablok regression analysis showed that both CBCT and 99mTc-MAA SPECT/CT had proportional biases and thus tendencies to overestimate DT and DPL at higher post-treatment doses.ConclusionCBCT may be a reliable segmentation method, but it does not significantly increase the accuracy of dose prediction compared with that of 99mTc-MAA SPECT/CT. At higher doses both methods tend to overestimate the doses to tumors and perfused livers.
Keywords:Brachytherapy  Radiation dosimetry  Yttrium-90  Carcinoma  hepatocellular  Cone-beam CT  SPECT CT  Yttrium-90  95% confidence interval  Technetium-99m  Barcelona Clinic Liver Cancer  Cone-beam computed tomography  Catheter-directed computed tomography hepatic angiography  Computed tomography  Intraclass coefficient correlation  Hepatocellular carcinoma  Macroaggregated albumin  Model for End-stage Liver Disease  Medical internal radiation dose  Magnetic resonance imaging  Positron emission tomography  First quartile  Third quartile  Selective internal radiation therapy  Single-photon emission computed tomography/computed tomography  Standard deviation  Tumor-to-normal tissue ratio  Volume-of-interest
本文献已被 ScienceDirect 等数据库收录!
设为首页 | 免责声明 | 关于勤云 | 加入收藏

Copyright©北京勤云科技发展有限公司  京ICP备09084417号