Study-Parameter Impact in Quantitative 90-Yttrium PET Imaging for Radioembolization Treatment Monitoring and Dosimetry

A small positron-generating branch in 90-Yttrium (90Y) decay enables post-therapy dose assessment in liver cancer radioembolization treatment. The aim of this study was to validate clinical 90Y positron emission tomography (PET) quantification, focusing on scanner linearity as well as acquisition and reconstruction parameter impact on scanner calibration. Data from three dedicated phantom studies (activity range: 55.2 MBq-2.1 GBq) carried out on a Philips Gemini TF 16 PET/CT scanner were analyzed after reconstruction with up to 361 parameter configurations. For activities above 200 MBq, scanner linearity could be confirmed with relative error margins <;4%. An acquisition-time-normalized calibration factor of 1.04 MBq·s/CNTS was determined for the employed scanner. Stable activity convergence was found in hot phantom regions with relative differences in summed image intensities between -3.6% and +2.4%. Absolute differences in background noise artifacts between - 79.9% and + 350% were observed. Quantitative accuracy was dominated by subset size selection in the reconstruction. Using adequate segmentation and optimized acquisition parameters, the average activity recovery error induced by the axial scanner sensitivity profile was reduced to +2.4%±3.4% (mean ± standard deviation). We conclude that post-therapy dose assessment in 90Y PET can be improved using adapted parameter setups.

[1]  Robert M. Lewitt,et al.  Application of the row action maximum likelihood algorithm with spherical basis functions to clinical PET imaging , 2001 .

[2]  A. Paradiso,et al.  Yttrium-90 (90Y) in the principal radionuclide therapies: an efficacy correlation between peptide receptor radionuclide therapy, radioimmunotherapy and transarterial radioembolization therapy. Ten years of experience (1999-2009). , 2011, Critical reviews in oncology/hematology.

[3]  F. Forrer,et al.  EANM procedure guideline for the treatment of liver cancer and liver metastases with intra-arterial radioactive compounds , 2011, European Journal of Nuclear Medicine and Molecular Imaging.

[4]  Renaud Lhommel,et al.  Yttrium-90 TOF PET scan demonstrates high-resolution biodistribution after liver SIRT , 2009, European Journal of Nuclear Medicine and Molecular Imaging.

[5]  Kenneth G. Thurston,et al.  Radioembolization with yttrium-90 microspheres: a state-of-the-art brachytherapy treatment for primary and secondary liver malignancies: part 3: comprehensive literature review and future direction. , 2006, Journal of vascular and interventional radiology : JVIR.

[6]  Katia Parodi,et al.  PET/CT imaging for treatment verification after proton therapy: a study with plastic phantoms and metallic implants. , 2007, Medical physics.

[7]  S. Walrand,et al.  4-Step Renal Dosimetry Dependent on Cortex Geometry Applied to 90Y Peptide Receptor Radiotherapy: Evaluation Using a Fillable Kidney Phantom Imaged by 90Y PET , 2010, The Journal of Nuclear Medicine.

[8]  S. Vandenberghe,et al.  Comparison of yttrium-90 quantitative imaging by TOF and non-TOF PET in a phantom of liver selective internal radiotherapy , 2011, Physics in medicine and biology.

[9]  S. Walrand,et al.  Yttrium-90-labeled microsphere tracking during liver selective internal radiotherapy by bremsstrahlung pinhole SPECT: feasibility study and evaluation in an abdominal phantom , 2011, EJNMMI research.

[10]  F. Mottaghy,et al.  Selective internal radiation therapy (SIRT) in primary or secondary liver cancer. , 2011, Methods.

[11]  R. Mansberg,et al.  Yttrium 90 Bremsstrahlung SPECT/CT scan demonstrating areas of tracer/tumour uptake , 2007, European Journal of Nuclear Medicine and Molecular Imaging.

[12]  S. Houle,et al.  Treatment of nonresectable hepatocellular carcinoma with intrahepatic 90Y-microspheres. , 2000, Journal of nuclear medicine : official publication, Society of Nuclear Medicine.

[13]  H. Amthauer,et al.  Matched-Pair Comparison of Radioembolization Plus Best Supportive Care Versus Best Supportive Care Alone for Chemotherapy Refractory Liver-Dominant Colorectal Metastases , 2012, CardioVascular and Interventional Radiology.

[14]  L. V. Elmbt,et al.  Feasibility of 90Y TOF PET-based dosimetry in liver metastasis therapy using SIR-Spheres , 2010, European Journal of Nuclear Medicine and Molecular Imaging.

[15]  M. Abecassis,et al.  Radiation Lobectomy: Preliminary Findings of Hepatic Volumetric Response to Lobar Yttrium-90 Radioembolization , 2009, Annals of Surgical Oncology.

[16]  J. Karp,et al.  Systematic and Distributed Time-of-Flight List Mode PET Reconstruction , 2006, 2006 IEEE Nuclear Science Symposium Conference Record.

[17]  P. Flamen,et al.  New Imaging Techniques for 90 Y Microsphere Radioembolization , 2011 .

[18]  P. Flamen,et al.  Multimodality imaging can predict the metabolic response of unresectable colorectal liver metastases to radioembolization therapy with Yttrium-90 labeled resin microspheres , 2008, Physics in medicine and biology.

[19]  Til Aach,et al.  Activity quantification combining conjugate-view planar scintigraphies and SPECT/CT data for patient-specific 3-D dosimetry in radionuclide therapy , 2011, European Journal of Nuclear Medicine and Molecular Imaging.