Abstract
A uniform distribution of yttrium-90 (90Y) microspheres throughout the entire liver has always been assumed for dose calculation in treating hepatic tumours. A simple mathematical model was formulated which allows estimation of the activities of a therapeutic dose of90Y microspheres partitioned between the lungs, the tumour and the normal liver, and hence the radiation doses to them. The doses to the tumour and normal liver were verified by intra-operative direct beta-probing. The percentage of activity shunted to the lung and the tumour-to-normal tissue ratio (T/N) were obtained from gamma scintigraphy using technetium-99m-labelled macroaggregated albumin (MAA) which simulates the90Y microspheres used in subsequent treatment. The intrahepatic activity was partitioned between the tumour and the normal liver based on the T/N and their masses determined from computerized tomography slices. The corresponding radiation doses were computed using the MIRD formula. The estimated radiation doses were correlated with the doses directly measured using a calibrated beta-probe at laparotomy by linear regression. The radiation doses to the tumour and the normal liver, estimated using the partition model, were close to that measured directly with coefficients of correlation for linear regression: 0.862 for the tumours and 0.804 for the normal liver compartment (P<0.001). The partition model permits a distinction between the radiation doses received by the tumour and the normal liver to be made and the doses thus estimated are close to the actual doses received. The optimal doses to the tumour and normal liver and hence the required quantity of90Y microspheres to be administered can be easily predetermined.
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References
Ariel IM. Treatment of inoperable primary pancreatic and liver cancer by the intra-arterial administration of radioactive isotopes (Y90 radiating microspheres).Ann Surg 1965; 162: 267–278.
Ariel IM, Pack GT. Treatment of inoperable cancer by intraarterial radioactive isotopes and chemotherapy.Cancer 1967; 20: 793–804.
Grady ED. Internal radiation therapy of hepatic cancer.Dis Colon Rectum 1979; 22: 371–375.
Mantravadi RVP, Spigos DG, Tan WS, Felix EL. Intraarterial yttrium 90 in the treatment of hepatic malignancy.Radiology 1982; 142: 783–786.
Ariel IM, Padula G. Treatment of asymptomatic metastatic cancer to the liver from primary colon and rectal cancer by the intraarterial administration of chemotherapy and radioactive isotopes.J Surg Oncol 1982; 20: 151–156.
Herba MJ, Illescase FF, Thirlwell MP etal. Hepatic malignancies: improved treatment with intraarterial Y-90.Radiology 1988; 169: 311–314.
Blanchard RJW, Morrow IM, Sutherland JB. Treatment of liver tumours with yttrium-90 microspheres alone.J Can Assoc Radiol 1989; 40: 206–210.
Houle S, Yip TCK, Shepherd FA etal. Hepatocellular carcinoma: pilot trial of treatment with Y-90 microspheres.Radiology 1989; 172: 857–860.
Shepherd FA, Rostein LE, Houle S, Yip TCK, Paul K, Sniderman KW. A phase I dose escalation trial of yttrium-90 microspheres in the treatment of primary hepatocellular carcinoma.Cancer 1992; 70: 2250–2254.
Andrews JC, Walker SC, Ackermann RJ, Cotton LA, Ensminger WD, Shapiro B. Hepatic radioembolization with yttrium90 containing glass microspheres: preliminity results and clinical follow-up.J Nucl Med 1994; 35: 1637–1644.
Synder WS, Ford MR, Warner GG, Watson SB. “S” absorbed dose per unit cumulative activity for selected radionuclides and organs NM/MIRD. Pamphlet No. 11. New York: Society of Nuclear Medicine, 1975.
Zeissman HA, Thrall JH, Yang PJ etal. Hepatic arterial perfusion scintigraphy with Tc-99m MAA.Radiology 1984; 152: 167–172.
Goldberg JA, Bradnam MS, Kerr DJ etal. Arteriovenous shunting of microspheres in patients with colorectal liver metastases: error in assessment due to free pertechnetate, and the effect of angiotensin II.Nucl Med Commun 1987; 8: 1033–1046.
Lau WY, Leung TWT, Ho S etal. Diagnostic pharmacoscintigraphy with technetium-99m macroaggregated albumin in the prediction of tumour to normal uptake ratio during therapy of inoperable hepatocellular carcinoma with yttrium-90 microspheres.Br J Radiol 1994; 67: 136–139.
Leung WT, Lau WY, Ho S etal. Measuring lung shunting in hepatocellular carcinoma with intra-arterial technetium-99m macroaggregated albumin.J Nucl Med 1994; 35: 70–73.
Lau WY, Leung WT, Ho S etal. Treatment of inoperable hepatocellular carcinoma with intrahepatic arterial yttrium-90 microspheres: a phase I and II study.Br J Cancer 1994; 70: 994–999.
Burton MA, Gray BN, Jones C, Coletti A. Intraoperative dosimetry of90Y in liver tissue.Nucl Med Biol 1989; 16: 495–498.
Burton MA, Gray BN, Klemp PF, Kelleher DK, Hardy N. Selective internal radiation therapy: distribution of radiation in the liver.Eur J Cancer Clin Oncol 1989; 25: 1487–1491.
Burton MA, Gray BN, Kelleher DK, Klemp PF. Selective internal radiation therapy: validation of intraoperative dosimetry.Radiology 1990; 175: 253–255.
Gray BN, Burton MA, Kelleher D, Klemp P, Matz L. Tolerance of the liver to the effects of yttrium-90 radiation.Int J Radiat Oncol Biol Phys 1990; 18: 619–623.
Weber DA, Eckeman KF, Dillman LT, Ryman JC.MIRD: radionuclide data and decay schemes. New York: Society of Nuclear Medicine; 1989: 159.
Shen S, DeNardo GL, DeNardo SJ. Quantitative bremsstrahlung imaging of yttrium-90 using a Wiener filter.Med Phys 1994; 21: 1409–1417.
Lau WY, Li AKC. Therapeutic aspects of radioisotopes in hepatobiliary malignancy.Br J Surg 1992; 79: 711.
Siegel JA, Handy DM, Kopher KA, Zeiger LS, Order SE. Therapeutic beta irradiating isotopes in bony metastases: a technique for bremsstrahlung imaging and quantitation.Antibody Immunoconj Radiopharm 1992; 5: 237–248.
Order SE, Siegel JA, Lusting RA etal. Infusional brachytherapy in the treatment of nonresectable pancreatic cancer: a new radiation modality (preliminary report of the phase I study).Antibody Immunoconj Radiopharm 1994; 7: 11–27.
Siegel JA, Zeiger LS, Order SE, Wallner PE. Quantitative bremsstrahlung single photon emission computed tomographic image use for volume, activity, and absorbed dose calculation.Int J Radiat Oncol Biol Phys 1995; 31: 953–958.
Feinendegen LE. Microdosimetric considerations of hepatic radioembolization [editorial].J Nucl Med 1994; 35: 1644–1645.
Fox RA, Klemp PFB, Egan G, Mina LL, Burton MA, Gray BN. Dose distribution following selective internal radiation therapy.Int J Radiat Oncol Biol Phys 1991; 21: 463–467.
Roberson, Ten Haken RK, Mcshan DL, McKeever PE, Ensminger WD. Three dimensional tumour dosimetry for hepatic yttrium-90-microsphere therapy.J Nucl Med 1992; 33: 735–738.
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Ho, S., Lau, W.Y., Leung, T.W.T. et al. Partition model for estimating radiation doses from yttrium-90 microspheres in treating hepatic tumours. Eur J Nucl Med 23, 947–952 (1996). https://doi.org/10.1007/BF01084369
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DOI: https://doi.org/10.1007/BF01084369