Scholarlink

Purpose <p>Dosimetry-guided treatment planning is central to radioembolization. Guidelines recommend segmenting volumes on baseline contrast-enhanced CT (ceCT) and registering to a SPECT/low-dose CT. However, this conventional approach is vulnerable to spatial misregistration and potential disease progression. This study evaluates a hybrid SPECT/ceCT-based planning methodology, hypothesising that it yields significantly different dosimetry metrics compared to the conventional workflow.</p> Materials and methods <p>Hybrid SPECT/ceCT was performed in 24 patients with hepatocellular carcinoma. Treatment planning followed both the conventional and hybrid workflow, where delineation was performed directly on SPECT/ceCT. Quantification of dosimetric and positional differences between volumes from the two workflows was performed using Simplicit<sup>90</sup>Y (Mirada Medical) and SurePlan Liver Y90 (MIM) software, respectively. Outcomes were evaluated by Bland-Altman analysis and contour intercomparison indices.</p> Results <p>Direct delineation on SPECT/ceCT yielded higher index lesion (largest single tumour) doses (6% increased) (mean: 19.5&#xa0;Gy, 95% limits of agreement [LoA]: -43.9&#xa0;Gy, 83.0&#xa0;Gy) and lower normal tissue doses (11% decrease) (mean: -17.6&#xa0;Gy 95% LoA: -104.4&#xa0;Gy, 69.3&#xa0;Gy). Index lesion volume increase between baseline CT and SPECT/ceCT was 14% (95% LoA: -55.9%, 82.9%). Index lesion dose (<i>p</i> = 0.01) and volume (<i>p</i> = 0.01) differed significantly between workflows. The median time interval between baseline imaging and SPECT/ceCT was 6 weeks (IQR: 3.7 to 9.3 weeks). The median deviation of the index lesion between the baseline diagnostic image and hybrid SPECT/ceCT image was 4.9 ± 2.2&#xa0;mm and there was an average DICE score of 0.6 ± 0.2.</p> Conclusion <p>Hybrid [99mTc]Tc-MAA SPECT/ceCT treatment planning is technically feasible and leads to significant differences in dosimetry metrics compared with the conventional method.</p>

错误：搜索内容不能为空，请输入英文关键词
错误：关键词超出字数限制，请精简
高级检索

A novel approach to radioembolization treatment planning using a hybrid [99mTc]Tc-MAA contrast enhanced SPECT/CT

  • 期刊论文

  • 出版模式：

    开放获取

  • 发表日期：

    2026年7月11日

查看全文
  • Grace Keane,
  • Marnix. G. E. H. Lam,
  • Maarten. L. J. Smits,
  • Guus. M. Bol,
  • Hugo. W. A. M. de Jong,
  • Rutger. C. G Bruijnen,
  • Arthur. J. A. T. Braat

摘要

Purpose

Dosimetry-guided treatment planning is central to radioembolization. Guidelines recommend segmenting volumes on baseline contrast-enhanced CT (ceCT) and registering to a SPECT/low-dose CT. However, this conventional approach is vulnerable to spatial misregistration and potential disease progression. This study evaluates a hybrid SPECT/ceCT-based planning methodology, hypothesising that it yields significantly different dosimetry metrics compared to the conventional workflow.

Materials and methods

Hybrid SPECT/ceCT was performed in 24 patients with hepatocellular carcinoma. Treatment planning followed both the conventional and hybrid workflow, where delineation was performed directly on SPECT/ceCT. Quantification of dosimetric and positional differences between volumes from the two workflows was performed using Simplicit90Y (Mirada Medical) and SurePlan Liver Y90 (MIM) software, respectively. Outcomes were evaluated by Bland-Altman analysis and contour intercomparison indices.

Results

Direct delineation on SPECT/ceCT yielded higher index lesion (largest single tumour) doses (6% increased) (mean: 19.5 Gy, 95% limits of agreement [LoA]: -43.9 Gy, 83.0 Gy) and lower normal tissue doses (11% decrease) (mean: -17.6 Gy 95% LoA: -104.4 Gy, 69.3 Gy). Index lesion volume increase between baseline CT and SPECT/ceCT was 14% (95% LoA: -55.9%, 82.9%). Index lesion dose (p = 0.01) and volume (p = 0.01) differed significantly between workflows. The median time interval between baseline imaging and SPECT/ceCT was 6 weeks (IQR: 3.7 to 9.3 weeks). The median deviation of the index lesion between the baseline diagnostic image and hybrid SPECT/ceCT image was 4.9 ± 2.2 mm and there was an average DICE score of 0.6 ± 0.2.

Conclusion

Hybrid [99mTc]Tc-MAA SPECT/ceCT treatment planning is technically feasible and leads to significant differences in dosimetry metrics compared with the conventional method.