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Evaluation of sequential SPECT and CT for targeted radionuclide therapy dosimetry

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Abstract

Purpose

In targeted radionuclide therapy (TRT), a prior knowledge of the absorbed dose biodistribution is essential for pre-therapy treatment planning. Previously, we showed that non-rigid organ-by-organ registration in sequential quantitative SPECT images improved dose estimation. This study aims to investigate if sequential CT can further improve TRT dosimetric accuracy.

Methods

We simulated SPECT/CT acquisitions at 1, 12, 24, 72 and 144 h In-111 Zevalin post-injection using an analytical MEGP projector, modeling attenuation, scatter and collimator-detector response. We later recruited a patient injected with 222 MBq In-111 DTPAOC imaged at 3 SPECT/CT sessions for clinical evaluations. Four registration schemes were evaluated: whole-body-based registration performed on sequential (1) SPECT (WB-SPECT) or (2) CT (WB-CT) images; organ-based registration applied on organs individually segmented from sequential (3) SPECT (O-SPECT) or (4) CT (O-CT) images. Voxel-by-voxel integration was performed followed by Y-90 voxel-S-kernel convolution. Organ-absorbed doses, iso-dose curves, dose–volume histograms (DVHs) were generated for targeted organs for analysis.

Results:

In simulation study, organ-absorbed dose errors were (− 8.66 ± 2.83)%, (− 2.51 ± 3.69)%, (− 9.23 ± 3.28)%, (− 7.17 ± 2.53)% for liver, (− 14.81 ± 4.91)%, (− 3.60 ± 4.37)%, (− 18.13 ± 4.44)%, (− 11.34 ± 4.22)% for spleen, for O-SPECT, O-CT, WB-SPECT and WB-CT registrations, respectively. For all organs, O-CT showed superior results. Results of iso-dose contour, DVHs were in accordance with the organ-absorbed doses. In clinical studies, the results were also consistent which showed O-CT method deviated the most from the result with no registration.

Conclusions:

We conclude that if both sequential SPECT/CT scans are available, CT organ-based registration method can more effectively improve the 3D dose estimation. Sequential low-dose CT scans might be considered to be included in the standard TRT protocol.

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Acknowledgements

The majority of this work was performed at the University of Macau. The authors would like to thank Division of Medical Imaging Physics, Russell H. Morgan Department of Radiology and Radiological Science at Johns Hopkins University for providing the reconstruction software. This work was supported by research Grants from University of Macau [MYRG2016-00091-FST and MYRG2017-00060-FST]; Fundo para o Desenvolvimento das Ciencias e da Tecnologia, Macau [114/2016/A3]; and National Natural Science Foundation of China [81601525].

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Authors and Affiliations

  1. Biomedical Imaging Laboratory, Department of Electrical and Computer Engineering, Faculty of Science and Technology, University of Macau, Macau SAR, China

    Tiantian Li & Greta S. P. Mok

  2. Department of Biomedical Imaging and Radiological Sciences, National Yang Ming University, Taipei, Taiwan, Republic of China

    Nien-Yun Wu

  3. Department of Nuclear Medicine, Taipei Veterans General Hospital, Taipei, Taiwan, Republic of China

    Nien-Yun Wu

  4. Department of Nuclear Medicine, Albert Einstein College of Medicine, Yeshiva University, Bronx, New York, 10461, USA

    Na Song

  5. Faculty of Health Sciences, University of Macau, Macau SAR, China

    Greta S. P. Mok

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  1. Tiantian Li
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Correspondence to Greta S. P. Mok.

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Li, T., Wu, NY., Song, N. et al. Evaluation of sequential SPECT and CT for targeted radionuclide therapy dosimetry. Ann Nucl Med 32, 34–43 (2018). https://doi.org/10.1007/s12149-017-1218-8

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